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Postoperative transient reduced diffusion in the ipsilateral striatum and thalamus
1Department of Radiology, National Center Hospital of Neurology and Psychiatry, Kodaira, Tokyo, Japan.
AJNR. American Journal of Neuroradiology
|August 18, 2012
Summary
Transient reduced diffusion in the brain
Area of Science:
- Neuroimaging
- Neuronal Degeneration
- Cerebral Surgery
Background:
- Secondary neuronal degeneration, like Wallerian degeneration, can cause restricted diffusion.
- Postoperative changes in the brain require careful interpretation.
Purpose of the Study:
- To investigate transient reduced diffusion in the striatum and thalamus after cerebral surgery.
- To understand this as a potential remote effect of surgery.
Main Methods:
- Retrospective review of 602 postoperative MRI scans from 125 patients.
- Analysis of diffusion restriction in the striatum and thalamus, correlating with surgical site.
- Exclusion of acute infarctions and review of patient neurologic status.
Main Results:
- Reduced diffusion observed in 13.6% of patients in the striatum and/or thalamus ipsilateral to surgery.
- Diffusion abnormalities showed a characteristic distribution linked to surgical location and neural connections.
- These changes appeared 7-46 days post-op and fully resolved on follow-up MRI.
Conclusions:
- Postoperative transient reduced diffusion in the striatum/thalamus indicates early secondary neuronal degeneration.
- This finding should be differentiated from postoperative ischemic injury.
