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Middle cerebral artery strokes causing homonymous hemianopia: positron emission tomography
M Kiyosawa1, T M Bosley, M Kushner
1Department of Nuclear Medicine, University of Pennsylvania, Philadelphia.
Annals of Neurology
|August 1, 1990
Summary
Stroke impacts brain metabolism, even in areas not visibly damaged. This study reveals significant glucose hypometabolism in visual cortex regions following middle cerebral artery strokes, affecting both hemispheres.
Area of Science:
- Neuroscience
- Medical Imaging
- Neurology
Background:
- Stroke, particularly involving the middle cerebral artery, can lead to visual field deficits like homonymous hemianopia.
- Assessing brain metabolism post-stroke is crucial for understanding functional deficits beyond structural damage.
Purpose of the Study:
- To investigate glucose metabolism changes in the brain after isolated middle cerebral artery territory strokes causing homonymous hemianopia.
- To quantify metabolic alterations in both affected and unaffected hemispheres, focusing on visual cortex areas.
Main Methods:
- Utilized 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) in eight patients.
- Evaluations were conducted 3 to 30 days post-stroke.
Main Results:
- Diffuse hypometabolism was observed throughout the stroke-affected cerebral hemisphere.
- Significant reductions in glucose metabolism were found in the primary and association visual cortex of the damaged hemisphere (>47%).
- The unaffected hemisphere also showed decreased metabolism, notably in the calcarine (40%) and lateral occipital cortex (35%).
Conclusions:
- Middle cerebral artery strokes cause widespread cerebral hypometabolism, extending beyond clinically apparent ischemic areas.
- Visual cortex hypometabolism is a significant consequence, impacting both hemispheres, suggesting remote effects of the stroke.