Cerebral metabolites concentrations determined by quantitative proton MR spectroscopy in patients of intracerebral haematomas

ABSTRACT

This study was made to investigate serial metabolic changes in frontal lobes of patients with deep intracerebral hemorrhage [ICH] to found any correlation between N-acetylaspartate [NAA] and degree of motor impairment or clinical outcome. Forty three patients with deep ICH were examined with proton magnetic resonance spectroscopy by multivoxel method [voxel=10 X 10 X 20 mm; 64 voxels]. NAA/creatine ratios in the white matter of the primary motor and premotor areas on both sides were measured sequentially within 48 hours, at 2 weeks, and 1 month after onset using National Institutes of Health Stroke Scale We found, in the primary motor area on the affected side, the NAA/ creatine ratio decreased sequentially. At 48 hours and 2 weeks after onset, a negative correlation was detected between NAA/creatine and hematoma volume, but there was no correlation 1 month later. At 2 weeks, NAA/ creatine correlated negatively with motor impairment. In conclusions, there is delayed gradual reduction of NAA/creatine ratio in the frontal lobes correlating with motor deficit and clinical outcome after deep ICH