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Open Access Research article

Characteristics of injury of the corticospinal tract and corticoreticular pathway in hemiparetic patients with putaminal hemorrhage

Jin Sun Yoo1, Byung Yeon Choi2, Chul Hoon Chang2, Young Jin Jung2, Seong Ho Kim2 and Sung Ho Jang1*

Author Affiliations

1 Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, 317-1, Daemyungdong, Namku, Taegu 705-717, Republic of Korea

2 Department of Neurosurgery, College of Medicine Yeungnam University, Daegu, Republic of Korea

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BMC Neurology 2014, 14:121  doi:10.1186/1471-2377-14-121

Published: 6 June 2014

Abstract

Background

No study on the characteristics of injury of the corticospinal tract (CST) or corticoreticular pathway (CRP) in patients with putaminal hemorrhage has been reported. In this study, using diffusion tensor tractography, we attempted to investigate the characteristics of injury of the CST and CRP in hemiparetic patients with putaminal hemorrhage.

Method

Fifty seven consecutive patients with putaminal hemorrhage and 57 healthy control subjects were recruited for this study. Diffusion tensor imaging was performed during the early period (8 ~ 30 days) after onset. We defined injury of the CST or CRP in terms of the configuration (discontinuation of a neural tract) or abnormal DTT parameters (the fractional anisotrophy value or fiber number was more than two standard deviations lower than that of normal control subjects). The Motricity Index, the modified Brunnstrom Classification, and the Functional Ambulation Categories were used for evaluation of motor function.

Results

Among 57 patients, injury of the CST was found in 41 patients (71.9%) and injury of the CRP was found in 50 patients (87.8%), respectively, and 37 patients (64.9%) had injury of both the CST and CRP. All three motor functions of patients with injury of both the CST and CRP were significantly lower than those of patients with injury of either the CST or CRP (p < 0.05).

Conclusion

Our results indicate that the putaminal hemorrhage frequently accompanies injury of both the CST and CRP, and the CRP appears to be more vulnerable to putaminal hemorrhage than the CST. These findings suggest the necessity for evaluation of both the CRP and the CST in patients with putaminal hemorrhage.

Keywords:
Putaminal hemorrhage; Corticospinal tract; Corticoreticular pathway; Diffusion tensor imaging; Motor function