title: Evaluation of Cortical Brain Parenchyma by Diffusion and Perfusion MRI Before and After Chronic Subdural Hematoma Surgery.
abstract: OBJECTIVE
  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.
  
  
  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 cm2 regions of interest (ROI) 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Firat University, Department of Neurosurgery, Elazig, Turkey.
authors.forename: Bekir
authors.initials: B
authors.lastname: Akgun
authors.forename: Hakan
authors.initials: H
authors.lastname: Cakin
authors.forename: Sait
authors.initials: S
authors.lastname: Ozturk
authors.forename: Hanefi
authors.initials: H
authors.lastname: Yildirim
authors.forename: Izzet
authors.initials: I
authors.lastname: Okcesiz
authors.forename: Saim
authors.initials: S
authors.lastname: Kazan
authors.forename: Fatih Serhat
authors.initials: FS
authors.lastname: Erol
mesh_terms: D000328:Adult; D000368:Aged; D001921:Brain / Q000000981:diagnostic imaging* / Q000503:physiopathology; D002560:Cerebrovascular Circulation / Q000502:physiology*; D004322:Drainage / Q000379:methods; D005260:Female; D020200:Hematoma, Subdural, Chronic / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D011184:Postoperative Period