Mixed-signal intensity in preoperative T1 MRI might be associated with delayed postoperative hemorrhage in patients with intracranial epidermoid cyst

Abstract Objection Delayed postoperative hemorrhage (DPOH) was a severe postoperative complication after intracranial epidermoid cyst (EC) surgery. This study was designed to investigate possible clinical data and image features related to DPOH in EC patients. Material and Methods We retrospectively investigated 186 cases of EC and eight cases presented an appearance of DPOH. Preoperative magnetic resonance imaging(MRI)and clinical data (age, sex, chief surgeon, tumor size, tumor location and degree of resection) were reviewed and analyzed. Student's t-test and chi-square test were used and statistical significance was defined as P Results A total of eight patients suffered from DPOH. Seven patients (87.5%) with DPOH showed atypical mixed signal intensity on preoperative T1 MRI, compared with typical low-intensity in another DPOH case. Only one case of mixed signal intensity on T1 MRI was found in 178 patients without DPOH. The mixed signal intensity in preoperative T1 MRI was highly related to DPOH and mortality (both P Conclusion Mixed signal intensity on preoperative T1 MRI might be associated with DPOH in patients with EC. The surgeon should pay more attention to this rarely atypical imaging before surgery. Further observations are necessary to illustrate the relationship of mixed signal intensity and DPOH in EC and to guide reasonable therapy.