Evaluation of Cortical Brain Parenchyma by Diffusion and Perfusion MRI Before and After Chronic Subdural Hematoma Surgery.

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 subjects comprised 25 patients who underwent CSDH drainage. Brain diffusion and perfusion MRIs were obtained preoperatively, 48 h (early period) and 2 months (late period) postoperatively. Measurements were performed on 1 cm2 regions of interest in the neighboring parenchymal tissue. RESULTS The early postoperative diffusion values showed improvement compared to the preoperative values. The late postoperative values showed improvement compared to the preoperative and early postoperative values. The early postoperative perfusion values showed slight decline compared to the preoperative values. However, the late postoperative values showed improvement compared to the preoperative and early postoperative values. 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 early postoperative periods; slight impairment in perfusion may account for this. However, during late postoperative period, perfusion was seen to recover prominently.