Evaluation of cortical brain parenchyma, by diffusion and perfusion mri, before and after chronic subdural hematoma surgery

Abstract

ABSTRACTresponsible for the development of SDHs (2,7). The causative factors for SDHs include previous trauma, coagulopathies, intracranial hypotension, chronic alcoholism, vascular malformations, and intracranial masses (1). According to the time of development, SDHs that develop within the first 3 days are classified as acute SDHs, those that develop within 4-20 days are classified as sub-acute SDHs, and those that develop after 21 days are classified as chronic SDHs (CSDHs) (14). CSDHs reflect the organization of the █ INTRODUCTION I ntracranial subdural hematomas (SDHs) are hemorrhages that develop between the dura mater and the arachnoid mater and are likely to be associated with high mortality and morbidity. They are divided into three types as acute, sub-acute, and chronic, according to the time of development (7). Rupture of the parasagittal bridging veins, which course along the subdural distance, is classically shown as the factor AIM: To evaluate microcirculatory changes in neighboring parenchyma as a result of pressure due to chronic subdural hematoma (CSDH) in early and late periods after hematoma drainage. MATERIAL and METHODS:The subject group consisted of 25 patients who underwent CSDH drainage. Brain diffusion and perfusion magnetic resonance images (MRIs) were obtained preoperatively, and at 48 hours (early period) and 2 months (late period) postoperatively. Measurements were performed on 1 cm 2 regions of interest (ROI) in the neighboring parenchymal tissue. RESULTS: CONCLUSION:The fact that there was an increase in diffusion values from early to late postoperative periods, compared with the preoperative period, indicates that the beneficial effects of surgery increase over time. Brain perfusion was found to be slightly decreased in early postoperative period. Following CSDH drainage, neurological deteriorations are observed in some patients in the early postoperative periods; a slight impairment in perfusion may account for this. However, during the late postoperative period, perfusion was seen to recover prominently.

A Radiological Assessment of Chronic Subdural Hematomas

“…Kuwahara et al 36) reported that bleeding in the outer membrane could be confirmed using diffusion MRI. Furthermore, Akgun et al 1) reported cases with slightly decreased perfusion on early postoperative perfusion MRI and suggested that it was related to postoperative neurological deterioration.…”