Outcome Prediction by Combining Initial Clinical Severity With Corticospinal Tract Lesion Load in Patients With...

This study aimed to assess the predictive accuracy of motor outcomes in patients with intracerebral hemorrhage by integrating the initial severity of hemiparesis and the corticospinal tract lesion load (CST-LL).

A retrospective analysis was conducted on patients diagnosed with putaminal and/or thalamic hemorrhage who underwent computed tomography (CT) shortly after stroke onset. The CT images were aligned with a standardized brain template to calculate CST-LL. The initial severity of hemiparesis was evaluated using the summed Brunnstrom Recovery Stage (BRS total; range: 3-18). Motor outcomes at the time of discharge from a rehabilitation facility were assessed using the motor component total score of the Stroke Impairment Assessment Set (SIAS-motor total; range: 0-25). A multivariate regression analysis was performed with BRS total and CST-LL as independent variables and SIAS-motor total as the dependent variable.

A total of 61 patients were included in the analysis. The median CST-LL was 1.974 mL (interquartile range (IQR): 1.113-3.311 mL), the median BRS total was 8 (IQR: 4-13), and the median SIAS-motor total was 20 (IQR: 9.5-24.5). Both BRS total and CST-LL were found to be significant predictors of motor outcomes. The estimated t-values were 4.79 for BRS total and -3.29 for CST-LL, indicating comparable contributions of both factors. The developed regression model explained 60.4% of the variance in SIAS-motor outcomes.

The combination of initial clinical severity and CST-LL enhances the predictive accuracy of motor recovery in patients with intracerebral hemorrhage.