Rami Darwazeh1, Miao Wei2, Jianjun Zhong1, Zhaosi Zhang1, Fajin Lv2, Mazhar Darwazeh3, Yi Guo4, Yi Yan1, Samer S Hoz5, Xiaochuan Sun6. 1. Department of Neurosurgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China. 2. Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China. 3. Department of Neurosurgery, Specialized Arab Hospital, Nablus, Palestine. 4. Department of Radiology, Chongqing Emergency Medical Center, Chongqing, China. 5. Department of Neurosurgery, Neurosurgery Teaching Hospital, Baghdad, Iraq. 6. Department of Neurosurgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China. Electronic address: 779203374@qq.com.
Abstract
OBJECTIVE: Little is known about the pathophysiologic mechanisms of white matter injury after aneurysmal subarachnoid hemorrhage (aSAH). The purpose of this study is to investigate whether the mammillothalamic tract (MTT) or corticospinal tract (CST) is more affected by aSAH in the same patients with good outcome (Grade 5 on Glasgow Outcome Scale at 3 months) using diffusion tensor imaging (DTI). METHODS: Between June 2013 and September 2016, 21 patients with aSAH with good outcome and 21 sex- and age-matched normal healthy control participants were recruited. DTI was obtained at 8.92 ± 2.4 weeks after onset. Moreover, reconstruction of the CST and the MTT was completed with DTI-studio software. Apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values were measured. In addition, the motricity index and Mini-Mental State Examination scores were obtained. RESULTS: There was no statistically significant difference detected in the ADC and FA values of the CST between the patient and control groups (P > 0.05). On the contrary, there was a statistically significant difference in ADC and FA values of the MTT between the patient and control groups (P < 0.05). In addition, in the patient group, no correlation (P > 0.05) was observed between motricity index scores and DTI parameters (ADC and FA), whereas the Mini-Mental State Examination showed a positive correlation with FA (r = 0.591, P = 0.029) without correlation to ADC (r = 0.142, P = 0.628). CONCLUSIONS: Patients with good outcomes (Grade 5 on Glasgow Outcome Scale at 3 months) after aSAH appeared to suffer an injury of the MTT without an associated injury of the CST compared with the control group. This injury showed a correlation with cognitive dysfunction.
OBJECTIVE: Little is known about the pathophysiologic mechanisms of white matter injury after aneurysmal subarachnoid hemorrhage (aSAH). The purpose of this study is to investigate whether the mammillothalamic tract (MTT) or corticospinal tract (CST) is more affected by aSAH in the same patients with good outcome (Grade 5 on Glasgow Outcome Scale at 3 months) using diffusion tensor imaging (DTI). METHODS: Between June 2013 and September 2016, 21 patients with aSAH with good outcome and 21 sex- and age-matched normal healthy control participants were recruited. DTI was obtained at 8.92 ± 2.4 weeks after onset. Moreover, reconstruction of the CST and the MTT was completed with DTI-studio software. Apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values were measured. In addition, the motricity index and Mini-Mental State Examination scores were obtained. RESULTS: There was no statistically significant difference detected in the ADC and FA values of the CST between the patient and control groups (P > 0.05). On the contrary, there was a statistically significant difference in ADC and FA values of the MTT between the patient and control groups (P < 0.05). In addition, in the patient group, no correlation (P > 0.05) was observed between motricity index scores and DTI parameters (ADC and FA), whereas the Mini-Mental State Examination showed a positive correlation with FA (r = 0.591, P = 0.029) without correlation to ADC (r = 0.142, P = 0.628). CONCLUSIONS:Patients with good outcomes (Grade 5 on Glasgow Outcome Scale at 3 months) after aSAH appeared to suffer an injury of the MTT without an associated injury of the CST compared with the control group. This injury showed a correlation with cognitive dysfunction.
Authors: Samer S Hoz; Zahraa F Al-Sharshahi; Ignatius N Esene; Ali A Dolachee; Ali M Neamah; Aktham O Al-Khafaji; Mohammed A Al-Dhahir; Hatem Sadik Journal: Surg Neurol Int Date: 2021-05-17