{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,25]],"date-time":"2026-04-25T14:47:59Z","timestamp":1777128479160,"version":"3.51.4"},"reference-count":32,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n Background:<\/jats:title>\n Diffusion-weighted imaging (DWI) detects ischemic injury after microsurgical clipping of unruptured intracranial aneurysms (UIAs), yet non-ischemic parenchymal effects remain poorly characterized. This study evaluated early postoperative T2-weighted imaging (T2WI) abnormalities to characterize corridor-related tissue impact and identify anatomical determinants of non-ischemic parenchymal changes.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n This retrospective study analyzed 797 anterior circulation UIA clipping procedures performed by a single surgeon under uniform protocol. Early postoperative magnetic resonance imaging (day 4\u20135) and 12-month follow-up were obtained. T2WI hyperintensities without restricted diffusion were classified as non-ischemic parenchymal changes. Stratified analyses isolated the effects of aneurysm depth within trans-sylvian (TS) approaches and rectal gyrus separation within interhemispheric (IH) approaches. Multivariate regression identified independent predictors.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Non-ischemic T2WI changes occurred in 20.1% (160\/797) of procedures. IH approaches showed significantly higher incidence (50.7%) than TS approaches (13.8%,\n P<\/jats:italic>\n < 0.001). Within IH approaches, anterior communicating artery aneurysms demonstrated a higher incidence (68.8%) than distal anterior cerebral artery aneurysms (11.6%,\n P<\/jats:italic>\n < 0.001). Independent predictors included IH approach (odds ratio [OR] = 3.34,\n P<\/jats:italic>\n < 0.001), deep location (OR = 2.28,\n P<\/jats:italic>\n < 0.001), and aneurysm size \u22657 mm (OR = 1.71,\n P<\/jats:italic>\n = 0.015). At 12-month follow-up, 97.2% of lesions resolved or decreased. DWI-detected ischemia occurred in 7.0% of procedures. No permanent neurological deficits occurred.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Early postoperative T2WI abnormalities represent a distinct imaging signature of corridor-related tissue impact, strongly associated with approach depth and anatomy. Their reversibility indicates transient mechanical stress rather than permanent injury. T2WI serves as an objective biomarker complementing DWI-based assessment and may inform surgical quality monitoring and patient counseling.<\/jats:p>\n <\/jats:sec>","DOI":"10.25259\/sni_1309_2025","type":"journal-article","created":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T07:29:38Z","timestamp":1770362978000},"page":"71","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Early T2-weighted magnetic resonance imaging changes after microsurgical clipping of unruptured aneurysms: Biomarkers of corridor-related tissue impact"],"prefix":"10.25259","volume":"17","author":[{"given":"Shunsuke","family":"Kawamoto","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Dokkyo Medical University, Shimotsuga, Japan"},{"name":"Department of Neurosurgery, Nasu Red Cross Hospital, Otawara City, Tochigi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Go","family":"Ikeda","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Dokkyo Medical University, Shimotsuga, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shunsuke","family":"Fukaya","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Nasu Red Cross Hospital, Otawara City, Tochigi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kanae","family":"Okunuki","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Nasu Red Cross Hospital, Otawara City, Tochigi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroyoshi","family":"Akutsu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Dokkyo Medical University, Shimotsuga, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2026,2,6]]},"reference":[{"key":"10.25259\/SNI_1309_2025\/ref-1","doi-asserted-by":"crossref","first-page":"1124","DOI":"10.3171\/2019.5.JNS19373","article-title":"Clip-first policy versus coil-first policy for the exclusion of middle cerebral artery aneurysms","volume":"133","author":"Berro","year":"2020","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI_1309_2025\/ref-2","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1007\/s00234-005-1408-2","article-title":"Diffusion and perfusion MRI in patients with ruptured and unruptured intracranial aneurysms treated by endovascular coiling: Complications, procedural results, MR findings and clinical 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