Recovery of a partially damaged corticospinal tract in a patient with intracerebral hemorrhage: a diffusion tensor image study.
OBJECTIVE
We hypothesized that diffusion tensor imaging (DTI) could be useful for exploring corticospinal tract (CST) regeneration if longitudinal changes of diffusion anisotropy can be detected. In this study, we explored the recovery of a CST partially damaged by intracerebral hematoma in a patient by DTI.


METHODS
A 61-year-old female patient and six age-matched control subjects were evaluated. The patient presented with complete paralysis of the left extremities, which occurred at the onset of a spontaneous intracerebral hemorrhage (ICH) in the right corona radiata and internal capsule. Over the five-month period following onset, motor function of the affected extremities slowly recovered to the normal range. Two longitudinal DTIs were acquired from the patient (at 3 weeks and 5 months from onset) and one DTI from the control subjects. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) were measured using a region of interest (ROI) method.


RESULTS
On the 3-week DTI, FA values of ROIs in the ICH regions in the affected hemisphere were significantly lower, and ADC values of ROIs in the same areas were significantly higher than those of the control subjects (p<0.002). However, both mean FA and ADC values of the affected hemisphere in the 5-month DTI showed no significant differences versus those of the control.
Jang
Sung Ho
SH
Department of Physical Medicine and Rehabilitation, School of Medicine, Yeungnam University 317-1, Daemyungdong, Namku, Taegu, 705-717, Republic of Korea. strokerehab@hanmail.net
Byun
Woo Mok
WM
Han
Bong Soo
BS
Park
Hae-Jeong
HJ
Bai
Daiseg
D
Ahn
Young Hwan
YH
Kwon
Yong-Hyun
YH
Lee
Mi Young
MY
D000368:Aged; D001931:Brain Mapping; D016022:Case-Control Studies; D002543:Cerebral Hemorrhage / Q000473:pathology* / Q000503:physiopathology*; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D007839:Functional Laterality; D006801:Humans; D008875:Middle Aged; D011712:Pyramidal Tracts / Q000473:pathology / Q000503:physiopathology*; D020127:Recovery of Function / Q000502:physiology*; D013997:Time Factors