Corticospinal Tract Integrity in Acute Intracerebral Hemorrhage

  • Author / Creator
    McCourt, Rebecca C
  • Background: Intracerebral Hemorrhage (ICH) is associated with high morbidity and patients commonly suffer motor dysfunction. ICH volume is a significant predictor of outcome, and perihematoma edema may also represent tissue injury. Diffusion Tensor Imaging (DTI) can be used to assess in-vivo changes in tissue microstructure in white matter tracts, such as the Corticospinal Tract (CST). Using DTI, the deleterious effects of the hematoma and perihematoma edema on CST integrity and motor outcome may be assessed. Methods: Patients with primary ICH underwent DTI at 72h, and days 7 and 30 after symptom onset. Diffusion metrics including Fractional Anisotropy (FA), a diffusion-based correlate for white matter integrity, were measured through the entire CST. Diffusion was also measured in the region of the ipsilateral CST that passed through the edema. Results: DTI demonstrates evidence of impairment in the CST after ICH. Larger hematoma volumes were associated with lower FA values at day 30 (β= -0.77; p=0.003). FA was decreased in the CST where it passes through the edema, but was not related to motor outcome. Conclusions: This study provides insight into the mechanisms of functional disability following hemorrhagic stroke. Hematoma volume is a mediating factor in white matter change after ICH, but diffusion changes in the perihematoma edema do not appear to be related to tract impairment.

  • Subjects / Keywords
  • Graduation date
    Fall 2016
  • Type of Item
  • Degree
    Master of Science
  • DOI
  • License
    This thesis is made available by the University of Alberta Libraries with permission of the copyright owner solely for non-commercial purposes. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.