Abstract 214: Corticospinal Tract Integrity is Acutely Maintained Within Perihematoma Edema
Bibliographic record
Abstract
Background: Perihematoma edema in intracerebral hemorrhage (ICH) is thought to be associated with tissue injury. Fractional Anisotropy (FA), as measured with Diffusion Tensor Imaging (DTI), can be used to assess white matter integrity. We tested the hypotheses that sections of the Corticospinal Tract (CST) passing directly through edema would 1) have low FA relative to the entire tract and 2) predict motor score in ICH patients. Methods: Patients were prospectively imaged with DTI within 14 days of symptom onset. Hematoma volume was measured on CT using planimetric techniques. Edema volume was assessed on CT using a 5-23 Hounsfield Unit threshold. Mean FA was measured in the edematous region (‘perihematoma edema'), the entire ipsilateral CST, and in the portion of CST passing through the perihematoma edema ('edematous CST'). Motor function was evaluated with a composite of the upper and lower extremity NIHSS motor score (0=normal, 8=hemiplegia). Results: Patients (n=27, mean age 67±13) were scanned with DTI at a median of 2 (3) days. Hematoma distribution was: lobar 5 (18%), basal ganglia 21 (78%), and brainstem 1 (4%). Median acute ICH volume was 8.2 (22) ml at 2 (2)h. Acute edema volume was 0.9 (1.8) ml and grew to 1.9 (3.9) ml at 26h (26). NIHSS motor score was 3 (6) at 72h and 3 (7) at day 7. FA in the edema was significantly lower (0.23±0.06) than in contralateral mirror regions (0.37 ±0.07, p<0.0001). Mean FA in the edematous CST was lower (0.34±0.08) than FA in the entire ipsilateral CST (0.44±0.04, p<0.0001), but higher than FA in the perihematoma edema (0.25±0.06, p<0.0001). There was a weak correlation between FA in the edematous CST and 72h motor score (r= -0.40, p=0.050,) which disappeared at day 7 (r= -0.34, p=0.131). FA in the edematous CST was not related to time to scan (r=-0.027, p=0.892). Hematoma volume predicted FA in the edematous CST (ß=-0.46, 95% CI:[-0.05- -0.01]; p=0.015). Perihematoma edema volume did not predict FA in the edematous CST independently of the ICH (ß=-0.29, [-0.1-0.04]; p=0.475). Conclusion: FA is decreased in the CST where it passes through the edema, though not to the extent of the surrounding edema. The transient relationship between decreased FA and motor function suggests that edema temporarily impairs tract function but not integrity.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".