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Transient Ischemic Attack l: Introduction

Transient Ischemic Attack l: Introduction

A transient ischemic attack (TIA) is a brief episode of neurological dysfunction caused by a temporary, focal reduction in cerebral blood flow. Although symptoms resemble those of an ischemic stroke, the interruption in perfusion is short-lived and does not cause permanent infarction. TIAs are clinically important because they often serve as early warning events for future stroke.Mechanisms of Transient Cerebral IschemiaTransient cerebral ischemia may arise through several mechanisms. One...

Ischemic Stroke ll: Pathophysiology

Ischemic Stroke ll: Pathophysiology

An ischemic stroke occurs when a cerebral blood vessel becomes obstructed, most often by a thrombus or embolus, interrupting the delivery of oxygen and glucose to brain tissue. Because neurons rely on continuous aerobic metabolism, energy failure begins within minutes of reduced perfusion. The region receiving the least blood flow becomes the infarct core, an area of irreversible cellular death. Surrounding this core lies the penumbra, a zone of hypoperfused but still viable tissue that is...

Seizures: Classification

Seizures: Classification

Epilepsy is primarily characterized by unpredictable seizures, either provoked by an identifiable factor, such as injury or illness, or unprovoked, occurring spontaneously without apparent cause.
Seizures are typically classified into two main categories: focal and generalized seizures.
Focal Seizures
Focal seizures originate from specific regions of the brain. These seizures are further sub-classified into two types:

Ischemic Stroke l: Introduction

Ischemic Stroke l: Introduction

Ischemic stroke is an acute cerebrovascular condition in which blood flow to a brain region is suddenly interrupted, leading to tissue infarction. Neurons depend on continuous oxygen and glucose supply, so even brief reductions in perfusion cause energy failure, ionic imbalance, and irreversible injury. Ischemic strokes are classified into thrombotic and embolic types based on their underlying mechanisms.Thrombotic MechanismsThrombotic stroke develops when a clot forms within a cerebral artery.

Hemorrhagic Stroke ll: Pathophysiology

Hemorrhagic Stroke ll: Pathophysiology

A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...

Seizures ll: Types

Seizures ll: Types

Seizures are sudden bursts of abnormal electrical discharge in the brain that interfere with normal function. They are commonly divided into three groups: focal seizures, generalized seizures, and other types that do not fit neatly into either category.Focal SeizuresFocal seizures begin in a single brain region. When awareness is preserved, they are called focal aware seizures and may cause sensations such as tingling, unusual smells, or flashing lights. When awareness is impaired, they are...

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Related Experiment Video

Updated: Jun 9, 2026

Assessing Cortical Cerebral Microinfarcts on High Resolution MR Images

Assessing Cortical Cerebral Microinfarcts on High Resolution MR Images

Published on: November 20, 2015

Cortex on Fire: Infarct Mimicking Ictal.

Hala Jasim¹, Alex Heglin, Orhan K Öz

¹Department of Radiology, UT Southwestern Medical Center, Dallas, TX.

Clinical Nuclear Medicine

|June 8, 2026

Summary

This summary is machine-generated.

This study introduces triaxial metabolic diaschisis (TMDS), a novel brain imaging pattern seen in a patient with small cell lung cancer. TMDS reveals unique metabolic changes distinct from stroke or seizures.

Keywords:

FDG PET/CT crossed cerebellar diaschisis triaxial metabolic diaschisis

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Modeling Stroke in Mice: Permanent Coagulation of the Distal Middle Cerebral Artery

Modeling Stroke in Mice: Permanent Coagulation of the Distal Middle Cerebral Artery

Published on: July 31, 2014

Area of Science:

Neurology
Nuclear Medicine
Oncology

Background:

Recurrent stroke-like symptoms and seizures can present diagnostic challenges.
Small cell lung cancer survivors may experience neurological complications.
Distinguishing between stroke, seizures, and other neurological conditions is crucial for effective treatment.

Purpose of the Study:

To describe a novel metabolic imaging pattern observed in a patient with recurrent neurological symptoms.
To differentiate this pattern from known neuroimaging findings in stroke and seizures.
To propose a new term, triaxial metabolic diaschisis (TMDS), for this distinct metabolic signature.

Main Methods:

A 65-year-old woman with treated small cell lung cancer and neurological symptoms underwent Magnetic Resonance Imaging (MRI) and Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (FDG PET/CT).
MRI was used to assess structural brain changes, specifically looking for diffusion restriction.
FDG PET/CT was employed to evaluate brain metabolic activity, identifying areas of increased or decreased glucose uptake.

Main Results:

Brain MRI revealed diffusion restriction, indicative of acute neurological injury.
FDG PET/CT demonstrated an unusual metabolic pattern: intense left frontoparietal cortical uptake ('cortex on fire') with decreased uptake in the ipsilateral thalamus and contralateral cerebellum ('ice in thalamus and cerebellum').
This pattern was termed triaxial metabolic diaschisis (TMDS), characterized by discordant metabolic changes, differentiating it from concordant hypometabolism in ischemic stroke or hypermetabolism in seizures.

Conclusions:

Triaxial metabolic diaschisis (TMDS) represents a novel pattern of discordant metabolic changes in the brain.
TMDS is distinct from the metabolic patterns associated with ischemic stroke and ictal seizures.
The findings suggest that the observed left frontal uptake in TMDS may not be secondary to direct neuronal activity, warranting further investigation.