High resolution SPECT, small deep infarcts and diaschisis.

Area of Science:

• Neurology
• Radiology
• Neuroimaging

Background:

• Lacunar infarction is a common type of stroke.
• Diaschisis, characterized by reduced cerebral perfusion, is often observed in stroke cases.
• The clinical significance of diaschisis in lacunar infarction requires further clarification.

Purpose of the Study:

• To investigate the relationship between diaschisis and clinical deficits in patients with lacunar infarction.
• To evaluate the temporal changes in cerebral perfusion using SPECT imaging.
• To assess the clinical relevance of diaschisis in the context of lacunar stroke.

Main Methods:

• Serial high-resolution single photon emission computerized tomography (SPECT) using 99Tcm HMPAO was performed on 18 lacunar infarction patients.
• Clinical deficits, including purely motor deficits, were assessed at presentation and over time.
• The degree and extent of diaschisis were quantified and compared with clinical severity.

Main Results:

• No significant correlation was found between the presence or extent of diaschisis and the severity of the clinical deficit at any stage.
• Changes in cerebral perfusion consistent with diaschisis were observed but did not correlate with clinical presentation or recovery.
• Six cases presented with purely motor deficits, but diaschisis did not show a specific correlation with this subtype.

Conclusions:

• The study suggests that diaschisis may be present in lacunar infarction without a direct correlation to the clinical deficit.
• Caution is advised when attributing clinical features solely to diaschisis in lacunar stroke.
• Further research is needed to fully understand the role and implications of diaschisis in stroke pathophysiology.