The purpose of this study was to evaluate the applicability of diffusion tensor MR imaging (DTI) and fiber tractography (FT) for the prediction of short-term functional motor outcome in patients with spontaneous deep intracerebral hemorrhage (ICH).

DTI and FT were performed in 18 patients with deep ICH within seven days after onset. Fractional anisotropy (FA) values were measured in the posterior limb of internal capsules bilaterally, and the ratio of values (hematoma side/contralateral side) was determined as the FA ratio. Patterns of corticospinal tract alteration were categorized according to the anatomical relationship between the corticospinal tract and ICH. Motor impairment was assessed on admission and at one month after onset. The FA ratio, patterns of corticospinal tract alteration and degree of motor impairment were analyzed for correlation.

The FA ratio measured shortly after the onset of ICH correlated with motor function on admission and motor outcome at one month (p < 0.01). Good motor functional outcome was seen in all patients with an FA ratio greater than 0.8. An initial corticospinal tract injury on FT correlated with motor function on admission and motor outcome at one month (p < 0.05).

Early evaluation of corticospinal tract injury based on the use of DTI and FT can provide predictive value for short-term functional motor outcome in patients with deep ICH.