Brain, Vol. 109, No. 4, 677-694, 1986
© 1986 Guarantors of Brain
research-article |
CROSSED CEREBELLAR DIASCHISIS
FURTHER STUDIES
1Service Hospitalier Frédéric Joliot, CEA, Départment de Biologue Orsay 2Clinique des Maladies du Système Nerveux, Hôpital de la Salpétrière Paris, France
Correspondence to:
Correspondence to: Dr J. C. Baron, Service Hospitalier Frederic Joliot, CEA, Departement de Biologie, 91406 Orsay, France.
SUMMARY
To investigate further the topographical, clinical and temporal correlates of crossed cerebellar diaschisis (CCD) after supratentorial stroke, 55 patients suffering from a single unilateral ischaemic stroke in the carotid artery territory were studied with the quantitative oxygen-15 steady-state technique and positron tomography. Fourteen patients had one or more follow-up studies, contributing a total of 72 studies. The phenomenon of CCD, defined by depressed oxygen consumption in the contralateral cerebellum, was statistically significant in 58% of the studies It was more prominent when the supratentorial infarct involved the internal capsule or the cortical mantle extensively, consistent with the hypothesis that it results from destruction of the corticopontocerebellar fibres. Although CCD was associated with the presence of hemiparesis, it also occurred in patients without hemiparesis and was not seen in all those with hemiparesis, suggesting that destruction of the pyramidal tract is neither necessary nor sufficient to induce CCD Finally, CCD tended to persist over long periods of time after a stroke, pointing towards a transneuronal degeneration possibly akin to crossed cerebellar atrophy as a likely explanation for CCD Nevertheless, CCD could be seen within hours of a stroke and sometimes disappeared within a few days, suggesting a temporal continuum between early, potentially reversible functional hypometabolism (diaschisis) and irreversible degeneration.
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Received June 21, 1985. Revised September 12, 1985. Accepted November 22, 1985.
*On leave for III Cattedra Neurologica, Roma, 00184, Italy.
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