Contralateral flow reduction in unilateral stroke: evidence for transhemispheric diaschisis.

Lagrèze, H. L.; Levine, Ross L.; Pedula, Kathryn L.; Nickles, Robert J.; Sunderland, John; Rowe, B.

doi:10.1161/01.str.18.5.882

Cited by 61 publications

(28 citation statements)

References 17 publications

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“…These reductions were small and were not accompanied by decreases in right SEP amplitudes. Contralateral reduction of CBF has been described experimentally 18 and clinically 19 and has been attributed to transcallosal diaschisis. 19 - 20 However, contralateral CBF reductions in the other three groups were minor.…”

Section: Resultsmentioning

confidence: 99%

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Consistency of cerebral blood flow and evoked potential alterations with reversible focal ischemia in cats.

Matsumiya

Koehler

Traystman

1990

Stroke

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To enhance the consistency of the ischemic insult caused by reversible transorbital middle cerebral artery occlusion, we investigated the variability of somatosensory evoked potential amplitudes and regional cerebral blood flow in 26 anesthetized cats using four procedures to induce transient ischemia. These procedures included 60 minutes of left middle cerebral artery occlusion with or without left common carotid artery occlusion and 120 minutes of left middle cerebral artery occlusion with or without bilateral common carotid artery occlusion. Blood flow in the left middle cerebral artery territory was markedly and consistently reduced to <20 ml/min/100 g with simultaneous occlusion of the left middle cerebral artery and both common carotid arteries. The standard deviation of blood flow with this procedure (5.4) was less than that with the other three procedures (13-25). The amplitudes of ipsilateral somatosensory evoked potentials were decreased to approximately 20% of control during ischemia with all four procedures. During reperfusion, amplitudes recovered more slowly, to half of control, after both procedures involving 120 minutes of ischemia. After 120 minutes of reperfusion, the range of amplitudes was smallest in the group exposed to middle cerebral artery occlusion with bilateral common carotid artery occlusion. The degree of recovery of the somatosensory evoked potentials correlated with residual blood flow in both the ipsilateral middle cerebral artery territory and in the white matter during ischemia. We conclude that the most consistent model of focal ischemia and reperfusion in cats in which there is partial recovery of somatosensory evoked potentials is occlusion of one middle cerebral artery and both common carotid arteries for 120 minutes. (Stroke 1990:21:908-916)

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Section: Resultsmentioning

confidence: 99%

“…Contralateral reduction of CBF has been described experimentally 18 and clinically 19 and has been attributed to transcallosal diaschisis. 19 - 20 However, contralateral CBF reductions in the other three groups were minor. Thus, contralateral CBF reduction in group MCABCCAO-120 can be largely attributed to the bilateral CCA occlusion.…”

Section: Resultsmentioning

confidence: 99%

Consistency of cerebral blood flow and evoked potential alterations with reversible focal ischemia in cats.

Matsumiya

Koehler

Traystman

1990

Stroke

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“…ischemia [6, 7, 8, 9, 10, 11, 21, 22]. Diaschisis has been predominantly observed in 3 types of ischemic strokes: (a) in the cerebellum contralateral to a supratentorial lesion [10, 21, 23, 24]; (b) in the unaffected hemisphere as a result of a cortical lesion [6, 7, 8, 9, 10, 11, 12], and (c) in the cortex after a deep …”

Section: Discussionmentioning

confidence: 99%

“…Unfortunately, excluding a few case reports of crossed cerebellar diaschisis [21, 23, 27], no studies have been performed in humans in the initial hours after ischemic events. In the current study, the occurrence of transhemispheric diaschisis, already observed in the subacute and chronic stages [6, 7, 8, 9, 10, 11, 12, 22], was evaluated for the first time within the first few hours from the ischemic stroke. There is only one other clinical study that has estimated the occurrence of diaschisis in the unaffected hemisphere (through an analysis of its metabolism) in the acute stage (within 18 h, mean 11 h).…”

Section: Discussionmentioning

confidence: 99%

“…The few clinical CBF studies on acute stroke have focused only on the injured hemisphere, without concern for the remote effects of the infarct in the unaffected brain [1, 2, 3, 4, 5]. More data are available in the subacute and chronic time periods, where a reduction of the CBF in the contralateral hemisphere [6, 7, 8, 9, 10, 11, 12]or in the whole brain [13, 14]has been reported. It is unknown, however, if transhemispheric depression of the blood flow is present in the first few hours of the stroke.…”

Section: Introductionmentioning

confidence: 99%

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Remote Effects of Acute Ischemic Stroke: A Xenon CT Cerebral Blood Flow Study

Rubin

Levy²,

Scarrow³

et al. 2000

Cerebrovasc Dis

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Objective: The purpose of this study was to verify transhemispheric diaschisis in the early hours after an ischemic event. Methods: XeCT cerebral blood flow (CBF) studies within 8 h of stroke were studied in 23 patients. Mean CBF was evaluated in the ischemic area, contralateral hemisphere and ipsilateral cerebellum. Results: A severe CBF reduction was found in the ischemic area (mean 9 ± 3 ml/100 g/min). The mean CBF in the unaffected hemisphere (33 ± 10 ml/100 g/min) was 35% less compared to the normal mean value. CBF was decreased in the cerebellum ipsilateral to the stroke (mean 31 ± 12 ml/100 g/min) suggesting a blood flow depression of the whole brain. Conclusions: During the initial hours of cerebral ischemia, the asymptomatic hemisphere demonstrated CBF depression that was part of the global flow reduction.

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