Multimodal imaging of recovery of functional networks associated with reversal of paradoxical herniation after cranioplasty

Cranioplasty following decompressive craniectomy is reported to result in improved blood flow, cerebral metabolism, and concomitant neurological recovery. We used multimodal functional imaging technology to study a patient with marked neurological recovery after cranioplasty. Resting-state networks and auditory responses obtained with functional MRI and cerebral metabolism obtained with PET before and after cranioplasty revealed significant functional changes that were correlated with the subject's neurological recovery. Our results suggest a link between recovery of behavior, cerebral metabolism, and resting-state networks following cranioplasty.