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Early MR abnormality indicating functional recovery from spontaneous intracerebral hemorrhage
1Division of Neurosurgery, Hideshima Hospital, Tokyo.
Abstract:
Magnetic resonance (MR) imaging as an indicator of recovery from hemiparesis was evaluated in 60 patients with spontaneous intracerebral hemorrhage. T2-weighted MR images revealed early MR abnormality (EMA) of the corticospinal tract within 1 week of ictus. Most patients without EMA recovered beyond Brunnstrom's Recovery Stage 3 while only a few patients with EMA did so. Patients with EMA cannot regain motor function because EMA is almost always followed by complete tract degeneration. EMA in the brainstem and poor motor function recovery are closely correlated.
Insights
Early MR abnormality (EMA) on T2-weighted MRI within 1 week of stroke predicts poor motor function recovery in intracerebral hemorrhage patients. Most patients without EMA regained significant motor function, unlike those with EMA.
Area of Science:
- Neurology
- Radiology
- Neuroimaging
Background:
- Spontaneous intracerebral hemorrhage frequently leads to hemiparesis.
- Assessing recovery potential early is crucial for patient management.
- Magnetic resonance (MR) imaging offers insights into brain tissue changes.
Purpose of the Study:
- To evaluate the utility of MR imaging in predicting motor recovery after intracerebral hemorrhage.
- To determine if early MR imaging findings correlate with functional outcomes.
Main Methods:
- Sixty patients with spontaneous intracerebral hemorrhage were assessed.
- T2-weighted MR images were analyzed within 1 week of ictus.
- Correlation between early MR abnormality (EMA) of the corticospinal tract and motor function recovery (Brunnstrom's Recovery Stage) was examined.
Main Results:
- Early MR abnormality (EMA) of the corticospinal tract was identified within 1 week in some patients.
- Patients without EMA showed significant motor recovery (beyond Stage 3), while few with EMA did.
- EMA was strongly associated with poor motor function recovery, often preceding complete tract degeneration.
- EMA in the brainstem correlated with poor motor outcomes.
Conclusions:
- Early MR imaging, specifically T2-weighted sequences detecting EMA, is a valuable predictor of motor recovery after intracerebral hemorrhage.
- The presence of EMA suggests irreversible corticospinal tract damage, limiting functional recovery.
- Early identification of EMA can help set realistic expectations for patients and guide rehabilitation strategies.