| Motor Outcomes in Patients with Hemorrhagic Stroke in the Basal Ganglia and Thalamus |
|
Sung Kyun Chung , Jong Sik Suk , Jeong Taik Kwon , Yong Sook Park |
|
Department of Neurosurgery, Chung-Ang University College of Medicine, Seoul, Korea |
|
|
| Abstract |
Objective
The outcomes of intracerebral hemorrhage are variable in terms of volume, location, or pre existing morbidities. We assessed motor outcome in patients who had a spontaneous cerebral hemorrhage confined to deep nuclei and adjacent white matter.
Methods
The inclusion criteria were hemorrhage within the basal ganglia (BG) or thalamus, at least 6 months’ follow up and available for serial brain imaging and medical records. Upper and lower extremities motor function was assessed. Motor states were divided into a good and a poor group. The characteristics of the BG and thalamus hematoma were investigated. Age, gender, volume of hemorrhage, GCS, computed tomography classification of the locations, GOS, intraventricular hemorrhage, and operation were compared. We particularly focused on damaged subcortical structures (putamen, globus pallidus, thalamus, internal capsule, and corona radiata) that differentially affected motor outcome.
Results
One hundred twenty‐four patients were included in the study. The internal capsule (IC) of posterior limb, globus pallidus, and corona radiata (middle and posterior third portion lesions) were more involved in the poor motor group of the upper extremities and the lateral thalamus, IC posterior limb, and all portions of the corona radiata lesions were more involved in the poor motor group of the lower extremities. Multiple regression analysis demonstrated that the posterior third of the corona radiata lesion was an independent predictor for poor motor outcome. The age was significantly older in the thalamic group. Hematoma volume was larger in the BG group. The frequency of corona radiata involvement was 13 (17.1%) of 76 in the BG group and 22 (61.1%) of 36 in the thalamic group. The thalamic hematomas more frequently involved the corona radiata.
Conclusion
Either BG or thalamic hematomas involving the mid to posterior of the corona radiata showed poor motor outcomes, which seems to represent the corticospinal tract injury. There needs to be a study of the validity of CT on predicting the motor outcomes in the patients with hemorrhagic strokes. |
| Key Words:
Basal gangliaㆍComputed tomographyㆍIntracerebral hemorrhageㆍOutcomeㆍThalamus |
|
PDF Links
Download Citation
