This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Yamauchi, H. Articles by Kimura, J. Search for Related Content PubMed PubMed Citation Articles by Yamauchi, H. Articles by Kimura, J.

Stroke, Vol 23, 855-860, Copyright © 1992 by American Heart Association

ARTICLES

Hemodynamic and metabolic changes in crossed cerebellar hypoperfusion

H Yamauchi, H Fukuyama and J Kimura
Department of Neurology, Faculty of Medicine, Kyoto University, Japan.

BACKGROUND AND PURPOSE: The pathophysiology of crossed cerebellar diaschisis remains to be elucidated. The mechanism responsible appears to be deafferentation through the corticopontocerebellar tract, which terminates in the cerebellar gray matter. However, few studies have demonstrated the hemodynamic and metabolic changes in the cerebellar gray matter and pons in crossed cerebellar diaschisis. METHODS: Using positron emission tomography in 24 patients with unilateral supratentorial stroke, we evaluated regional blood flow, metabolic rate of oxygen, oxygen extraction fraction, and blood volume in the cerebellar cortex and pons. Sixteen patients with significant cerebellar blood flow asymmetry, defined as a percentage difference in blood flow beyond the upper 95% confidence limit defined in eight normal subjects, were selected as the group with crossed cerebellar hypoperfusion. RESULTS: In patients with crossed cerebellar hypoperfusion, the metabolic rate of oxygen was significantly decreased in the cerebellar cortex contralateral to the supratentorial stroke, compared with that in the ipsilateral cerebellar cortex; this decrease was less than the decrease in cerebellar blood flow. The degrees of cerebellar asymmetry in these two parameters were negatively correlated with the metabolic rate of oxygen in the pons. The oxygen extraction fraction was slightly, but significantly, increased. In contrast to the ischemic state, however, the cerebellar blood volume was decreased, with no difference in the ratio of cerebellar blood flow to blood volume. CONCLUSIONS: These findings support interruption of the corticopontocerebellar tract as the mechanism of crossed cerebellar hypoperfusion. Our results also suggest a mild elevation in the oxygen extraction fraction in this state, with a mechanism distinct from ischemia.

This article has been cited by other articles:

				H. Yamauchi, T. Kudoh, Y. Kishibe, J. Iwasaki, and S. Kagawa Selective Neuronal Damage and Borderzone Infarction in Carotid Artery Occlusive Disease: A 11C-Flumazenil PET Study J. Nucl. Med., December 1, 2005; 46(12): 1973 - 1979. [Abstract] [Full Text] [PDF]

				H. Yamauchi, H. Okazawa, K. Sugimoto, Y. Kishibe, and M. Takahashi The Effect of Deafferentation on Cerebral Blood Flow Response to Acetazolamide AJNR Am. J. Neuroradiol., January 1, 2004; 25(1): 92 - 96. [Abstract] [Full Text] [PDF]

				H Yamauchi, H Okazawa, Y Kishibe, K Sugimoto, and M Takahashi Oxygen extraction fraction and acetazolamide reactivity in symptomatic carotid artery disease J. Neurol. Neurosurg. Psychiatry, January 1, 2004; 75(1): 33 - 37. [Abstract] [Full Text] [PDF]

				Z. G. Nadareishvili, D. E. Koziol, B. Szekely, C. Ruetzler, R. LaBiche, R. McCarron, T. J. DeGraba, and S. Jander Increased CD8+ T Cells Associated With Chlamydia pneumoniae in Symptomatic Carotid Plaque Editorial Comment Stroke, September 1, 2001; 32(9): 1966 - 1972. [Abstract] [Full Text] [PDF]

				H Yamauchi, H Fukuyama, Y Dong, H Nabatame, Y Nagahama, S Nishizawa, J Konishi, and H Shio Atrophy of the corpus callosum associated with a decrease in cortical benzodiazepine receptor in large cerebral arterial occlusive diseases J. Neurol. Neurosurg. Psychiatry, March 1, 2000; 68(3): 317 - 322. [Abstract] [Full Text] [PDF]

				H. Yamauchi, H. Fukuyama, Y. Nagahama, S. Nishizawa, and J. Konishi Uncoupling of Oxygen and Glucose Metabolism in Persistent Crossed Cerebellar Diaschisis Stroke, July 1, 1999; 30(7): 1424 - 1428. [Abstract] [Full Text] [PDF]

				H. Yamauchi, H. Fukuyama, Y. Nagahama, H. Okazawa, and J. Konishi A Decrease in Regional Cerebral Blood Volume and Hematocrit in Crossed Cerebellar Diaschisis Stroke, July 1, 1999; 30(7): 1429 - 1431. [Abstract] [Full Text] [PDF]

				H. Yamada, Y. Koshimoto, N. Sadato, Y. Kawashima, M. Tanaka, C. Tsuchida, M. Maeda, Y. Yonekura, and Y. Ishii Crossed Cerebellar Diaschisis: Assessment with Dynamic Susceptibility Contrast MR Imaging Radiology, February 1, 1999; 210(2): 558 - 562. [Abstract] [Full Text]

				M. E. Raichle Behind the scenes of functional brain imaging: A historical and physiological perspective PNAS, February 3, 1998; 95(3): 765 - 772. [Abstract] [Full Text] [PDF]

				B. Infeld, S. M. Davis, M. Lichtenstein, P. J. Mitchell, and J. L. Hopper Crossed Cerebellar Diaschisis and Brain Recovery After Stroke Stroke, January 1, 1995; 26(1): 90 - 95. [Abstract] [Full Text]