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TITLE:

PREDICTION OF MOTOR OUTCOME USING DTI, IN PATIENTS WITH HAEMORRHAGIC STROKE IN BASAL GANGLIA, CAUSED BY HYPERTENSION

AUTHORS:

Dr. Aman Ullah, Prof. Li Kun Zheng, Dr. Zhang Zheng Ping, Dr. Wen Shengbao, Dr. Wu Bin Jie, Dr. Guo Yan Jun, Ghulam Mustafa

ABSTRACT:

Background and Purpose: Predicting motor outcome in patients with hemorrhagic stroke due to hypertension can be a challenging task. Purpose of this research is to seek out whether using combination of clinical evaluation (using Brunnstrom scale, functional walking scale and modified Rankin Scale) and DTI-based assessment of coricospinal tract damage caused by hemorrhagic stroke can be promising or not to predict motor outcome in patients with hemorrhagic stroke in basal ganglia caused by hypertension. DTI was performed at 12 hours of symptoms onset after hemorrhagic stroke in basal ganglia to predict motor outcome at 3 months. Materials and Methods: In this study, 45 patients with hemorrhagic stroke in the basal ganglia caused by hypertension admitted in Qinghai University Affiliated Hospital from August 2019 to September 2019 were enrolled. Selected patients were diagnosed with hemorrhagic stroke by head CT scan. DTI was performed at 12 hours of symptom onset in selected patients with motor deficits secondary to hemorrhagic stroke. The evaluation index was based on Brunnstrom scale, functional walking scale and modified Rankin Scale to predict motor outcome clinically. Patients were divided into 4 groups based on the level of damage to CST. Subsequently, the assessment of hemorrhage in basal ganglia, perihematomal edema (edema location and volume) and corticospinal tract involvement was done. Corticospinal tract ratios for mean diffusivity and fractional anisotropy were also calculated. Results: In this study we found that for patients with hemorrhagic stroke in the basal ganglia caused by hypertension, the DTI can be used as an effective technique to predict the prognosis of motor function, as it is capable to evaluate the damage to CST. Furthermore, it can also be used as a guide to select a suitable plan for an effective physiotherapy for such patients. Conclusions: Combination of clinical evaluation of motor function and DTI-based assessment of damage to CST from hemorrhagic stroke in basal ganglia caused by hypertension, can accurately predict motor outcome. Keywords: DTI , Hemorrhagic Stroke, Motor Outcome Prediction, Basal Ganglia, corticospinal tract, Hypertension Abbreviations: DTI_diffusion tensor imaging; CST _ corticospinal tract; FA _ fractional anisotropy; ICH _ intracerebral hemorrhage; PHE _ perihematomal edema; rFA _ FA ratio ; HICH_Hypertensive intracerebral hemorrhage;PLIC_Posterior limb of internal capsule

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