Article

Middle cerebral artery (MCA) territory infarct is the most common
type of cerebral vascular territory infarct. Accurate prediction of motor outcome
is important for stroke rehabilitation. OBJECTIVES: We conducted an investigation
of prognostic factors of motor outcome in patients with a large MCAterritory
infarction, using diffusion tensor tractography (DTT) of the corticospinal tract
(CST). METHODS: A total of 37 consecutive hemiparetic patients with a large MCA
territory infarct were recruited for this study; DTT was performed within 5-30
days after onset. Patients were classified into three groups according to DTT
findings: in group A - CST integrity was preserved around infarct regions, in
group B - CSTs were discontinuous, and, in group C - the upper ends of CSTs did
not reach infarcted regions. Fractional anisotropy (FA) ratio of the affected CST
(versus the unaffected ipsilateral CST) was calculated, and evaluation of motor
function was performed using the Motricity Index (MI), modified Brunnstrom
classification (MBC) score, and the functional ambulation category (FAC) score at
onset and at six months after onset. RESULTS: Significantly greater changes in
motor function (MI, MBC, and FAC) were observed between onset and six months
post-onset in group A, compared with groups B and C (p < 0.05). However, no
significant difference was observed between groups B and C (p > 0.05). FA ratios
showed positive correlation with six-month MIs, and scores for MBC and FAC (p <
0.05). CONCLUSIONS: Results of this study demonstrate the usefulness of early DTT
findings of CSTs for prediction of motor outcome in patients with a large MCA
territory infarct.

Langue : ANGLAIS