Exploratory assessment of cerebrospinal fluid-related microdynamics after mild traumatic brain injury using intravoxel incoherent motion magnetic resonance imaging

This study aimed to characterize regional alterations in cerebrospinal fluid (CSF) microdynamics following mild traumatic brain injury (TBI) using intravoxel incoherent motion (IVIM) magnetic resonance imaging (MRI) and compare f-value-based CSF motion between patients with TBI and healthy controls.

In this prospective observational study, 14 patients with mild TBI and 14 healthy volunteers underwent IVIM MRI using a 3-Tesla scanner. The f-value, reflecting incoherent CSF-related microfluidic motion, was quantified across predefined supratentorial and infratentorial regions of interest. Group differences in mean f-values were evaluated, and longitudinal changes were assessed in three patients who underwent follow-up MRI.

The TBI group exhibited a significantly higher mean f-value in the left cerebellopontine angle (CPA) compared with controls. Exploratory trends toward lower f-values were also observed in several supratentorial regions, including the left lateral ventricle and right frontal subarachnoid space. Longitudinal analysis revealed increasing f-values in supratentorial regions over time-suggesting partial recovery-whereas infratentorial regions demonstrated decreasing or stable trajectories.

Mild TBI may be associated with region-specific alterations in CSF microdynamics, characterized by increased motion in the CPA and exploratory reductions in selected supratentorial regions. Although preliminary, these findings highlight the potential of IVIM MRI as a complementary tool for investigating post-traumatic abnormalities in CSF motion.