Elevated diffusion anisotropy in gray matter and the degree of brain compression: Clinical article
Abstract
Object: For several decades, clinicians have predicted intraparenchymal brain pressure or brain tissue compression indirectly based on the degree of distortion of the midline structures (midline shift) and ventricle wall (ventriculomegaly) observed on conventional MRI. However, this method has several limitations. Diffusion tensor imaging (DTI) is a novel MRI technique that can provide information about the microstructural properties of compressed tissue. In this study, the authors evaluated whether DTI can precisely define the degree of tissue compression in patients with chronic subdural hematoma (CSDH). Methods: The study sample consisted of 18 patients (mean age 71 years, 10 men and 8 women) with unilateral CSDH and 12 age-matched volunteers. Diffusion tensor imaging results were acquired before and after the surgical irrigation in the CSDH group. Subdural pressure during the operation was also measured. Fractional anisotropy (FA) values were evaluated at several locations, including the gray matter. Results: The FA values of the gray matter, especially in the caudate nucleus and putamen, were increased in the patients with CSDH compared with the control group. The change in FA data before and after surgery (ΔFA) correlated with the degree of tissue compression evaluated by measurement of the subdural pressure. Furthermore, the increased FA values in patients with CSDH decreased after surgery. Conclusions: These findings indicate that FA values of the gray matter, especially in the caudate nucleus and putamen, may be important markers of tissue compression. The assessment of FA values of the gray matter will result in a new, less-invasive diagnostic technique to evaluate the degree of brain compression.
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This hypothesis is consistent with increased FA in compressed brain tissue after hematoma.
“This hypothesis agrees with an increased FA in compressed brain tissue after hematoma (64).”
From Neuroanatomic differences associated with stress susceptibility and resilience (2016) · cites this paper as [64]
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- Authors
- Osuka, S., Matsushita, A., Ishikawa, E., Saotome, K., Yamamoto, T., Marushima, A., Satou, N., Zaboronok, A., Masumoto, T., & Matsumura, A.
- Affiliations
- University of Tsukuba (JP)
- Departments of Neurosurgery and
- Kobari General Hospital (JP)
- Radiology, Institute of Clinical Medicine, Graduate School of Comprehensive Human Sciences,
- Corresponding author
- Ishikawa, Eiichi
- ORCID
- Venue
- Journal of Neurosurgery
- Published
- 2012-08
- Volume
- 117
- Issue
- 2
- Pages
- 363-371
- ISSN
- 0022-3085 (ISSN-L)
- 1933-0693
- OpenAlex
- W1503773277
- Cited by
- 24
- References
- 29
- Citations by year
- 2026: 1 · 2024: 2 · 2023: 2 · 2022: 2 · 2021: 1 · 2020: 3 · 2019: 2 · 2017: 2 · 2016: 3 · 2015: 3 · 2014: 1 · 2013: 2
- FWCI
- 1.45
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of neurosurgery (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Japan Society for the Promotion of Science
- Topics
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advanced Neuroimaging Techniques and Applications
- Health Sciences › Medicine › Neurology › Neurosurgical Procedures and Complications
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advanced MRI Techniques and Applications
- Keywords
- chronic subdural hematoma, brain compression, diffusion anisotropy, fractional anisotropy, gray matter microstructure, caudate nucleus, putamen, surgical irrigation, diffusion tensor imaging
- MeSH terms
- Aged, Aged, 80 and over, Brain, Caudate Nucleus, Dementia, Dominance, Cerebral, Female, Humans, Image Enhancement, Image Interpretation, Computer-Assisted, Intracranial Pressure, Male, Middle Aged, Paresis, Postoperative Complications, Prospective Studies, Putamen, Trephining, Anisotropy, Hematoma, Subdural, Chronic, Gait Disorders, Neurologic, Diffusion Magnetic Resonance Imaging
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