Original Research Article
Year: 2018 | Month: November | Volume: 8 | Issue: 11 | Pages: 131-136
Evaluation of Changes in Cerebral Hemodynamics in Cranioplasty Patients Using Magnetic Resonance Perfusion
Chandan Misra1, T.K. Bandyopadhyay2, P.K. Chattopadhyay3, K Kamalpathey3, Uday Bhanu Kovilatu4
1Resident, 2Head of Department, 3Faculty, 4DM (Neuroradiology) Faculty,
Department of Oral and Maxillofacial Surgery, Army Dental Centre (Research & Referral), Delhi Cantt-10, New Delhi, India
Corresponding Author: Chandan Misra
Cranioplasty is the surgical repair of a residual calvarial bone defect secondary to decompressive craniectomy performed to relieve intractable intracranial hypertension. Although primary aim of cranioplasty is cosmetic rehabilitation and to provide mechanical protection to the brain, marked improvements in the neurological status after cranioplasty have been reported in several studies. The improvement might be secondary to a reduction of local cerebral compression effects by atmospheric pressure post cranioplasty leading to improved cerebral hemodynamics. This increased cerebral blood flow might result in the overall improvement in the neurologic parameters. Literature lacunae exist in correlating clinical symptoms with cerebral hemodynamics in cranioplasty patients using various imaging modalities. To overcome the radiation hazard drawbacks in conventional imaging modalities, evaluation of cerebral hemodynamics using “Magnetic Resonance Perfusion Imaging” has emerged as a feasible alternative with comparable results. Therefore, this prospective comparative study was undertaken to evaluate the changes in cerebral hemodynamics viz. cerebral blood flow, cerebral blood volume and mean transit time in cranioplasty patients using Magnetic resonance perfusion. The neurologic parameters were evaluated using global disability parameters namely Barthel index and Modified Rankin scale. The study emphasized to establish a correlation between the improved cerebrohemodynamic status and the neurologic improvement post cranioplasty.
Key words: Cranioplasty, Cerebral hemodynamics, Magnetic resonance perfusion.