Use of Diffusion Weighted Mriin Predicting Early Post-Operative Outcome of a New Neurological Deficit Afterbrain Tumor Resection

OBJECTIVE To study risk factors for the development of postoperative neurological deficits after brain tumor resection and to define prognostic factors for recovery. METHODS We prospectively studied 82 brain tumor patients undergoing tumor resection. Pre and postoperative neurological examination, functional and performance status, cancer treatment, cardiovascular risk factors, seizure history, and blood pressure and oxygen saturation peri-operatively were recorded. Postoperative MRIs were obtained within 72 hours of surgery and the radiologist was blinded to the patient's status. Abnormalities on diffusion weighted magnetic resonance images (DWI) were classified as new if they extended beyond the tumor cavity margins and were absent before surgery. RESULTS Of the 80 assessable patients, 24 had a new or increased postoperative deficit by at least one point on the National Institute of Health Stroke Scale. Presence of pre-operative neurological deficits predicted development of postoperative deficits, while a new DWI lesion after craniotomy predicted incomplete recovery of a new postoperative deficit. CONCLUSION Post operative diffusion MRI is useful in predicting early functional recovery from new deficits after brain tumor surgery.