title: Prolonged Cerebral Hyperperfusion and Subcortical Low Intensity on Fluid-Attenuated Inversion Recovery Images: Unusual Manifestation After Removal of Organized Chronic Subdural Hematoma.
abstract: BACKGROUND
  Cerebral hyperperfusion sometimes occurs after removal of chronic subdural hematoma (CSH) and usually resolves within a few days without any symptoms. Subcortical low intensity (SCLI) on fluid-attenuated inversion recovery (FLAIR) magnetic resonance images is rare and has been reported in some diseases other than CSH. A case of organized CSH who suffered prolonged neurologic deterioration, SCLI, and cerebral hyperperfusion postoperatively is described.
  
  
  METHODS
  An 81-year-old man, presenting with left hemiparesis, underwent craniotomy for right organized CSH after 2 burr-hole surgeries. After the craniotomy, the symptoms improved, but on postoperative day 2, left hemiparesis, hemispatial neglect, and hemiasomatognosia developed. Magnetic resonance imaging revealed SCLI on FLAIR images, and single-photon emission computed tomography with N-isopropyl-p-[123I]-iodoamphetamine revealed cerebral hyperperfusion in the right hemispheric cortex. Antihypertensive treatment improved the symptoms gradually, which resolved completely 1 month postsurgery.
  
  
  CONCLUSIONS
  A case of organized CSH, which showed postoperative neurologic deterioration associated with prolonged cerebral hyperperfusion and SCLI on FLAIR images, is reported. Prolonged cerebral hyperperfusion could be a cause of postoperative neurologic deterioration in organized CSH.
authors.affiliation: Department of Neurosurgery, Matsusaka Central General Hospital, Matsusaka, Mie, Japan. Electronic address: satoru-tanioka@umin.net.
authors.forename: Satoru
authors.initials: S
authors.lastname: Tanioka
authors.affiliation: Department of Neurosurgery, Matsusaka Central General Hospital, Matsusaka, Mie, Japan.
authors.forename: Yu
authors.initials: Y
authors.lastname: Sato
authors.affiliation: Department of Neurosurgery, Matsusaka Central General Hospital, Matsusaka, Mie, Japan.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Tsuda
authors.affiliation: Department of Neurosurgery, Matsusaka Central General Hospital, Matsusaka, Mie, Japan.
authors.forename: Shigehiko
authors.initials: S
authors.lastname: Niwa
authors.affiliation: Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan.
authors.forename: Hidenori
authors.initials: H
authors.lastname: Suzuki
mesh_terms: D000369:Aged, 80 and over; D002560:Cerebrovascular Circulation / Q000502:physiology; D020200:Hematoma, Subdural, Chronic / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D013997:Time Factors
keywords: Cerebral hyperperfusion; Organized chronic subdural hematoma; Subcortical low intensity on fluid-attenuated inversion recovery images