A subtle connection between crossed cerebellar diaschisis and supratentorial collateral circulation in subacute and chronic ischemic stroke |
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| Affiliation: | 1. Department of Radiology, University of Washington, 850 Republican St, Seattle, WA 98109, United States;2. Department of Bioengineering, University of Washington, United States;3. Department of Surgery, University of Washington, United States;4. Clinical Research Division, Fred Hutchinson Cancer Research Center, United States;1. Department of Neurosurgery, Soonchunhyang University Bucheon Hospital, 170, Jomaru-ro, Bucheon, Gyeonggi-Do 14584, Republic of Korea;2. Department of Neurosurgery, College of Medicine, St. Vincent''s Hospital, The Catholic University of Korea, Seoul, Republic of Korea;3. Department of Neurosurgery, Hangang Sacred Heart Hospital, Hallym University, Seoul, Republic of Korea;1. Division of Neurocritical Care, Montefiore Medical Center, Albert Einstein College of Medicine, NY, USA;2. Department of Neurology, Brigham and Women''s Hospital, Boston, MA, USA;3. Department of Neurology, Massachusetts General Hospital, Boston, MA, USA;4. Department of Pharmacy, Massachusetts General Hospital, Boston, MA, USA;5. Department of Pharmacy, Brigham and Women''s Hospital, Boston, MA, USA;6. Renal Division, Brigham and Women''s Hospital, Boston, MA, USA;7. Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Thailand;8. Department of Neurosurgery, Brigham and Women''s Hospital, Boston, MA, USA;1. Department of Comprehensive Strokology, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi 470-1101, Japan;2. Innovative and Clinical Research Promotion Center, Gifu University Hospital, Gifu, Japan;3. Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan;4. Department of Neurosurgery, Kokura Memorial Hospital, Fukuoka, Japan;5. Department of Neurosurgery, Fujita Health University School of Medicine, Aichi, Japan |
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| Abstract: | ObjectivesIt has not been reported whether collateral circulation, a factor closely related to the prognosis of patients with cerebral infarction, is related to the occurrence of crossed cerebellar diaschisis(CCD) or not. Our research attempts to verify the relationship between the collateral circulation grade and the occurrence of CCD, mainly by means of CTA and CTP.Materials and methodsA total of 47 patients were divided into a CCD-positive (Kim et al., 2019) or a CCD-negative group Furlanis et al. (2018) by calculating the asymmetry index (AI) value (<10%) of bilateral cerebellar cerebral blood flow (CBF). A 4-scale grading method was used to evaluate collateral circulation in the supratentorial infarct area, and the four perfusion parameters of the supratentorial and subtentorial brain regions were analyzed and compared between the two groups. The extent of vascular lesions was evaluated by MR sequences including DWI and MRA.ResultsAmong the four perfusion parameters, except for CBV, were significantly different between the bilateral cerebellum in the CCD-positive group, but only TTP in the supratentorial cerebral infarction area was statistically different in the two groups. Moreover, the collateral circulation sore in the CCD-positive group was significantly lower than that in the CCD-negative group. But no statistical difference was found in the comparison of DWI positive rates between the two groups.ConclusionThe collateral score in the supratentorial infarct area is correlated with the occurrence of CCD,which may be used to explain the effect of CCD on the prognosis of patients. |
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