Difference of recovery course of motor weakness according to state of corticospinal tract in putaminal hemorrhage.

OBJECTIVE

We investigated differences in recovery course of motor weakness according to the state of the corticospinal tract (CST) in putaminal hemorrhage, using diffusion tensor tractography (DTT).

METHODS

We recruited 36 patients with complete weakness of the affected extremities at onset. The patients were classified into two groups according to the findings of DTT for the CST at chronic stage: group A- preserved integrity of the CST around the lesion, and group B- discontinued integrity of the CST. Motor function of the affected extremities was measured over a six month period using the Motricity Index (MI).

RESULTS

The MI scores differed significantly each month, except at the onset, between group A and group B (p<0.05). In both groups, we observed significant increases between onset and one month, between one month and two months, between two month and three months, and between three months and four months (p<0.05). However, there were no significant increases after four months (p>0.05). The degree of difference between months was as follows: onset ∼1 month, 1 month ∼2months, 2 months ∼3months, and 3 months ∼4months.

CONCLUSIONS

Patients with preserved integrity of the CST showed better motor function than patients with discontinued integrity of the CST. In both groups, significant motor recovery was achieved during the first four months after onset. In addition, the most rapid motor recovery occurred during the first month and then decreased gradually with the passage of time.