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[Diaschisis in right putaminal hemorrhage: correlation with motor function]

K Ogasawara1, Y Numagami, M Kitahara

  • 1Department of Neurosurgery, Ishinomaki Red Cross Hospital.

No Shinkei Geka. Neurological Surgery
|December 1, 1994
PubMed
Summary

Local brain lesions can cause remote functional deficits, known as diaschisis. This study found that reduced blood flow in remote brain areas after right putaminal hemorrhage correlates with motor function recovery.

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Area of Science:

  • Neurology
  • Neuroscience
  • Radiology

Background:

  • Local cerebral lesions can induce functional deficits in remote brain areas via transneural mechanisms, termed diaschisis.
  • Understanding diaschisis is crucial for predicting functional outcomes after brain injury.

Purpose of the Study:

  • To investigate the relationship between motor function and diaschisis in patients with hypertensive right putaminal hemorrhage.
  • To assess regional brain blood flow in relation to motor deficits and recovery.

Main Methods:

  • Studied 33 patients with hypertensive right putaminal hemorrhage, treated conservatively, stereotaxically, or via craniotomy.
  • Measured regional brain blood flow in the right motor cortex and left cerebellar hemisphere using single photon emission CT (SPECT) with N-isopropyl-p-(123I)iodo-amphetamine.

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  • Evaluated blood flow using the E/D value (early image RI count/decay-corrected delayed image RI count) between 29-35 days post-onset.

    • Main Results:

    • A positive correlation was observed between motor function grade in the subacute stage and regional blood flow in the right motor cortex and left cerebellar hemisphere.
    • A positive correlation was also found between the Barthel index in the chronic stage (40-month follow-up) and regional blood flow in these areas.
    • These findings suggest diaschisis, or remote flow reduction, reflects internal capsule dysfunction and potential for recovery.

    Conclusions:

    • Regional brain blood flow in remote areas is a significant indicator of motor function and recovery potential after right putaminal hemorrhage.
    • Diaschisis following putaminal hemorrhage may provide insights into the extent of neurological damage and the capacity for rehabilitation.