White Matter Disconnection [Neurosurgery Wiki]

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====== White Matter Disconnection ======

===== 1. Definition =====
- **[[White matter]] [[disconnection]]** is the disruption of neural pathways linking different brain regions, caused by injury, disease, or surgery.

===== 2. Causes =====

^ Cause ^ Examples ^
| **Trauma** | Diffuse axonal injury |
| **Surgery** | Resection of brain tissue (e.g., epilepsy surgery) |
| **Stroke** | Ischemic damage to white matter tracts |
| **Tumors** | Compression or infiltration of tracts |
| **Neurodegeneration** | Multiple sclerosis, Alzheimer's disease |

===== 3. Consequences =====
- **Memory impairment** (e.g., disconnection of hippocampal tracts).
- **Language deficits** (e.g., arcuate fasciculus injury).
- **Motor weakness** (e.g., corticospinal tract disruption).
- **Executive dysfunction** (e.g., frontoparietal pathway damage).

===== 4. In Epilepsy Surgery =====
- Cognitive decline may occur due to injury to white matter pathways even when gray matter resection is limited.
- Key affected tracts:
  * **[[Uncinate fasciculus]]**
  * **[[Inferior longitudinal fasciculus]]**
  * **[[Fornix]]**

===== 5. Assessment Techniques =====

^ Method ^ Description ^
| **Diffusion Tensor Imaging (DTI)** | Maps white matter tracts via water diffusion |
| **Tractography** | 3D reconstruction of pathways |
| **Lesion-symptom mapping** | Correlation between injury site and clinical symptoms |

===== Summary =====
**White matter disconnection** disrupts brain network communication, leading to functional impairments.  
Preserving critical white matter tracts is essential in neurosurgery and neurorehabilitation.