Abstract
AIM: This study aimed to characterize regional alterations in cerebrospinal fluid (CSF) microdynamics following mild traumatic brain injury (TBI) using intravoxel incoherent motion (IVIM) magnetic resonance imaging (MRI) and compare f-value-based CSF motion between patients with TBI and healthy controls. METHODS: In this prospective observational study, 14 patients with mild TBI and 14 healthy volunteers underwent IVIM MRI using a 3-Tesla scanner. The f-value, reflecting incoherent CSF-related microfluidic motion, was quantified across predefined supratentorial and infratentorial regions of interest. Group differences in mean f-values were evaluated, and longitudinal changes were assessed in three patients who underwent follow-up MRI. RESULTS: The TBI group exhibited a significantly higher mean f-value in the left cerebellopontine angle (CPA) compared with controls. Exploratory trends toward lower f-values were also observed in several supratentorial regions, including the left lateral ventricle and right frontal subarachnoid space. Longitudinal analysis revealed increasing f-values in supratentorial regions over time-suggesting partial recovery-whereas infratentorial regions demonstrated decreasing or stable trajectories. CONCLUSION: Mild TBI may be associated with region-specific alterations in CSF microdynamics, characterized by increased motion in the CPA and exploratory reductions in selected supratentorial regions. Although preliminary, these findings highlight the potential of IVIM MRI as a complementary tool for investigating post-traumatic abnormalities in CSF motion.