No abstract available.
Ataxia ; Infarction* ; Internal Capsule ; Stroke

OBJECTIVES: The purpose of this study is to review our experience with spontaneous thalamic hemorrhage. Clinical outcome of patients was brought about by comparing stereotactic aspiration and conservative medical therapy. METHODS: The study consists of seventy-three cases with spontaneous thalamic hemorrhage which were treated from the period of Jan. 1993 to Dec. 1999. Thirty-eighty patients were treated with computed tomography (CT) guided stereotactic aspiration and thirty-five patients were treated conservatively. We compared the factors affecting treatment and the factors are as follows: age and sex, conscious level on admission, hematoma volume, hematoma sites, presence of ventricular penetration. RESULTS: The results in the thirty eight stereotactic aspirated cases for the 6 months from oneset are as follows: good recovery or moderate disability in 43%, severe disability in 32%, vegitative state in 11%, dead in 13% respectively. The clinical result was more favorable in stereotactic aspiration, with 11-30cc hematoma volume, extend to internal capsule of hematoma, poor conscious level on admission than conservative medical therapy. But age and sex, conscious level on admission, presence of ventricular penetration were not influential in the statistical outcome between stereotactic aspiration and conservative medical therapy. CONCLUSION: Treatment modality of spontaneous thalamic hemorrhage is still controversial. But stereotactic aspiration is more recommended for improvement therapeutic results than conservative treatment or open craniotomy in case of 11-30cc hematoma volume, extend to internal capsule of hematoma and poor conscious level on admission.
Craniotomy ; Hematoma* ; Hemorrhage ; Humans ; Internal Capsule

Neurological deficits commonly associated with anterior choroidal artery infarction (AChAI) include hemiplegia, hemisensory loss, and homonymous hemianopsia, while neuropsychological and perceptual deficits are uncommon. Prominent cognitive function impairment has rarely been reported. Here, we report a case of AChAI with prominent cognitive function impairment without motor deterioration. In contrast to the typical clinical features of AChAI, near complete and rapid motor recovery was observed, while cognitive impairment persisted despite rehabilitation therapy.
Cerebral Infarction* ; Hemianopsia ; Hemiplegia ; Internal Capsule ; Rehabilitation

BACKGROUND: One of the characteristics of hypoglycemic encephalopathy (HE) is selective vulnerability of different brain regions. CASE REPORT: We observed a patient with unilateral HE affecting the right internal capsule and the subcortical white matter. The patient had a preexisting stroke in the opposite hemisphere. The hemisphere that was affected by HE exhibited greater regional blood flow (single positron-emission tomography) and higher fractional anisotropy (diffusion-tensor imaging) than the unaffected hemisphere. CONCLUSIONS: This case suggests that the degree of metabolism required to maintain the function of brain structures and neuronal integrity is an important factor determining the selective vulnerability in HE.
Anisotropy ; Brain ; Humans ; Internal Capsule ; Neurons ; Regional Blood Flow ; Stroke

An AVM located in or adjacent to the sylvian fissure is one of the most difficult to remove because it is surrounded by critical structures such as the basal ganglia and internal capsule and it involves the middle cerebral artery. We have operated on 6 cases of arteriovenous malformation(AVM) in and around the sylvian fissure. We describe the characteristic features of these AVMs from the anatomical and surgical points of view. The surgical results were satisfactory in 5 cases, and 1 patients died.
Arteriovenous Malformations ; Basal Ganglia ; Humans ; Internal Capsule ; Middle Cerebral Artery

PURPOSE: It has been known that there are several areas of T2 hyperintensities in normal white matter of brain, such as terminal zones of myelination, ependymitis granularis, ones of posterior internal capsule, and perivascular space. The aim of our study is to demonstrate another region of T2 hyperintensities in normal pediatric age group. MATERIALS AND METHODS: We have studied brain MR for 10 normal volunteers and 35 patients without having intracranial lesions in pediatric age group(3-19 years). RESULTS: In 5 among 45 cases, focal T2 hyperintensities were seen in the parietal periventricular white matter beneath the postcentral gyri. They were noted as poorly defined, 5--10mm sized areas of increased signal intensities on T2 weighted axial images. They were also characterized by bilateral, posteromedially oriented, short band-like or oval areas. Interestingly, they were directly continuous with the T2 hyperintensity of posterior internal capsule. In spite of the relatively high frequency in the pediatric population as in our study, this finding has not been reported in the asymptomatic adults. CONCLUSION: The results show that the bilateral anterior parietal hyperintense areas may be another terminal zones of delayed myelination affecting the parietopontine tract. They should be differentiated from pathologic T2 hyperintensities by their characteristic findings.
Adult ; Brain ; Healthy Volunteers ; Humans ; Internal Capsule ; Myelin Sheath ; Rabeprazole*

The brain grows with age in non-human primates (NHPs). Therefore, atlas-based stereotactic coordinates cannot be used directly to target subcortical structures if the size of the animal's brain differs from that used in the stereotactic atlas. Furthermore, growth is non-uniform across different cortical regions, making it difficult to simply apply a single brain-expansion ratio. We determined the skull reference lines that best reflect changes in brain size along the X, Y, and Z axes and plotted the changes in reference-line length against the changes in body weight. The skull reference lines had a linear relationship with body weight. However, comparison of skull reference lines with body weight confirmed the non-uniform skull growth during postnatal development, with skull growth more prominent in the X and Y axes than the Z axis. Comparing the differences between the atlas-based lengths and those calculated empirically from plot-based linear fits, we created craniometric indices that can be used to modify stereotactic coordinates along all axes. We verified the accuracy of the corrected stereotactic targeting by infusing dye into internal capsule in euthanized and preserved NHP brains. Our axis-specific, craniometric-index-adjusted stereotactic targeting enabled us to correct for targeting errors arising from differences in brain size. Histological verification showed that the method was accurate to within 1 mm. Craniometric index-adjusted targeting is a simple and relatively accurate method that can be used for NHP stereotactic surgery in the general laboratory, without the need for high-resolution imaging.
Body Weight ; Brain ; Internal Capsule ; Methods ; Primates ; Skull

OBJECTIVE: The purpose of this study is to prove and quantify motor tract disruption and to correlate with motor weakness and its recovery in thalamic and putaminal hemorrhage using diffusion tensor magnetic resonance(MR) image. METHODS: We studied 24 patients with thalamic and putaminal hemorrhage with motor weakness who did not underwent surgery(hematoma volume < 25ml). We performed diffusion tensor MR image within a week, and then calculated FA(fractional anisotropy) index and FA ratio of posterior limb of internal capsule. We checked motor power of the patients at initial, 2 weeks, 1 month, 3 months and 6 months after hemorrhage. We divided patients into three groups according to FA ratio(group A: FA ratio < 50.0%, group B: FA ratio 50.0~75.0%, group C: FA ratio > 75.0%)and compared means of motor power at each time. RESULTS: The means of FA ratio were 42.5% in group A, 63.0% in group B and 88.2% in group C. The means of motor power were 1.1, 2.3 and 3.7 at initial. After 6 months the means of motor power were 3.0, 4.0 and 4.5. The group of lower FA ratio had more severe motor weakness and showed worse motor recovery clinically than the group of higher FA ratio(P < 0.01). Though patients had severe motor weakness initially, the patients with high FA ratio showed good recovery. CONCLUSION: In thalamic and putaminal hemorrhage, diffusion tensor MR image can prove the degree of motor tract damage and predict the degree of motor recovery.
Diagnosis* ; Diffusion* ; Extremities ; Hemorrhage ; Humans ; Internal Capsule ; Magnetic Resonance Imaging* ; Putaminal Hemorrhage*

A 63-year-old man was admitted with newly developed left hemiparesis. He had experienced left hemiparesis that had resulted from an earlier right thalamic hemorrhage. Diffusion-weighted images showed only high signal intensity lesion in the left internal capsule. Ipsilateral motor evoked potentials were obtained at the affected hand muscles when the unaffected motor cortex was stimulated. This suggests that cortical reorganization in the unaffected hemisphere after the first stroke may be involved in the occurrence of such symptom.
Evoked Potentials, Motor ; Hand ; Hemorrhage ; Humans ; Internal Capsule* ; Middle Aged ; Motor Cortex ; Muscles ; Paresis* ; Stroke*

We investigated 260 patients with the purpose of verifting the risk factors that determine lesion location and lesion volume. All the patients were subdibided into six lacunar syndrome subgroups (LSS) according to the clinical features, and also, into five lesion location subgroups(LSS) by neuroradiology findings. The common clinical syndromes were pure motor hemiparesis (32%) and sensorimotor stroke (30%). The mean lesion volume was large in pure sensory skoke and pure motor hem.paresis, and small in ataxic hemilaresis The common sites of lesion were internal capsule(32%) and basal ganglia(27%) In contrast with LSS, the risk factors and lesion volume were different among LLS. Patients with infratentorial lesion showed higher blood pressure than those with supratentorial lesion(p<0.05j. Lesion volume of corona radiata was greater than that of thalamus or internal capsule (p<005). Muliple lacunar lesions were associated with higher seurum hemoglobin concentration, men, and smoking (p<0.05). We suggest that (1) vlood pressure is of the contributing factors in determining the lesion location, (2) lesion volume is largest in lacunar infarction involving corona radiata, and (3) smol; ing is one of the important cause of multiple lacunar infarction.
Blood Pressure ; Humans ; Internal Capsule ; Male ; Paresis ; Risk Factors* ; Smoke ; Smoking ; Stroke ; Stroke, Lacunar* ; Thalamus