Evidence of corticospinal tract injury at midbrain in patients with subarachnoid hemorrhage.
OBJECTIVE
Clear elucidation of the exact pathophysiological mechanisms of motor weakness in patients with subarachnoid hemorrhage has not yet been achieved. We attempted to investigate injury to the corticospinal tract in patients with subarachnoid hemorrhage using diffusion tensor imaging.


METHODS
Twenty-two patients with subarachnoid hemorrhage and 24 control subjects were recruited for this study. DTI-Studio software was used for reconstruction of the corticospinal tract. We measured fractional anisotropy and apparent diffusion coefficient values at 5 regions of interest along the corticospinal tract pathway including: the corona radiata, the posterior limb of the internal capsule, the upper midbrain, the midpons, and the upper medulla.


RESULTS
Fractional anisotropy value for the midbrain region of interest was lower in the patient group compared with the control group without change of apparent diffusion coefficient value (P<0.05). By contrast, fractional anisotropy and apparent diffusion coefficient values of the other 4 regions of interest were not different between the patient and control groups.


CONCLUSIONS
Injury of the corticospinal tract at the midbrain was observed in patients with subarachnoid hemorrhage. Injury of the corticospinal tract at the midbrain appears to be one of the various pathophysiological mechanisms for motor weakness after subarachnoid hemorrhage.
Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Daemyungdong, Namku, Ta, Republic of Korea.
Sang Seok
SS
Yeo
Byung Yeon
BY
Choi
Chul Hoon
CH
Chang
Seong Ho
SH
Kim
Young-Jin
YJ
Jung
Sung Ho
SH
Jang
D000328:Adult; D000368:Aged; D016880:Anisotropy; D001921:Brain / Q000473:pathology; D056324:Diffusion Tensor Imaging; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008636:Mesencephalon / Q000473:pathology*; D008875:Middle Aged; D011712:Pyramidal Tracts / Q000473:pathology*; D012984:Software; D013345:Subarachnoid Hemorrhage / Q000473:pathology*