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A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia
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Crossed cerebellar hypoperfusion in hyperacute ischemic stroke

Masahiro Kamouchi1, Masatoshi Fujishima, Yoshisuke Saku

  • 1Division of Cerebrovascular Disorders, St. Mary's Hospital, Kurume, Fukuoka, Japan. kamouchi@intmed2.med.kyushu-u.ac.jp

Journal of the Neurological Sciences
|October 7, 2004
PubMed

Insights

Crossed cerebellar diaschisis, a depression in cerebellar blood flow, occurs in the hyperacute stage of middle cerebral artery infarction. This phenomenon is linked to reduced blood flow in the anterior frontal and temporal lobes.

Area of Science:

  • Neurology
  • Neuroimaging
  • Stroke Research

Background:

  • Crossed cerebellar diaschisis (CCD) is a known phenomenon in chronic cerebral hemispheric infarction, characterized by depressed contralateral cerebellar blood flow and metabolism.
  • The occurrence and underlying mechanisms of CCD in the hyperacute stage of ischemic stroke, particularly when infarction is not yet visible on computed tomography (CT), remain unclear.

Purpose of the Study:

  • To determine if crossed cerebellar diaschisis (CCD) manifests in the hyperacute stage of ischemic stroke.
  • To identify the specific cerebral lesion sites responsible for the depression in contralateral cerebellar blood flow during the hyperacute phase.

Main Methods:

  • Single photon emission computed tomography (SPECT) was utilized in 21 patients diagnosed with middle cerebral artery (MCA) embolic infarction within 6 hours of symptom onset.
  • Regions of interest (ROIs) were defined symmetrically in both cerebral and cerebellar hemispheres, including cortical and subcortical areas.

Main Results:

  • A significant increase in the side-to-side ratio of cerebellar blood flow was observed, indicating significantly depressed contralateral cerebellar blood flow compared to controls (P<0.001).
  • In the hyperacute stage, cerebellar blood flow ratios correlated with cerebral blood flow ratios in the whole hemispheres (r=0.44, P<0.05), anterior frontal lobe (r=0.44, P<0.05), and anterior temporal lobe (r=0.58, P<0.01), but not in the infarct areas.
  • Stepwise regression analysis identified a significant association between cerebellar hemisphere blood flow ratios and those in the anterior temporal lobe (multiple regression analysis, r=0.58, P<0.01).

Conclusions:

  • Crossed cerebellar diaschisis (CCD) is present in the hyperacute stage of middle cerebral artery infarction.
  • The observed CCD may be attributed to hypoperfusion in the anterior frontal and temporal lobes, resulting from ischemic infarction or diaschisis-induced ipsilateral hemispheric depression.
Abstract

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