title: Crossed cerebellar diaschisis in patients with acute middle cerebral artery infarction: Occurrence and perfusion characteristics.
abstract: We aimed to investigate the overall prevalence and possible factors influencing the occurrence of crossed cerebellar diaschisis after acute middle cerebral artery infarction using whole-brain CT perfusion. A total of 156 patients with unilateral hypoperfusion of the middle cerebral artery territory formed the study cohort; 352 patients without hypoperfusion served as controls. We performed blinded reading of different perfusion maps for the presence of crossed cerebellar diaschisis and determined the relative supratentorial and cerebellar perfusion reduction. Moreover, imaging patterns (location and volume of hypoperfusion) and clinical factors (age, sex, time from symptom onset) resulting in crossed cerebellar diaschisis were analysed. Crossed cerebellar diaschisis was detected in 35.3% of the patients with middle cerebral artery infarction. Crossed cerebellar diaschisis was significantly associated with hypoperfusion involving the left hemisphere, the frontal lobe and the thalamus. The degree of the relative supratentorial perfusion reduction was significantly more pronounced in crossed cerebellar diaschisis-positive patients but did not correlate with the relative cerebellar perfusion reduction. Our data suggest that (i) crossed cerebellar diaschisis is a common feature after middle cerebral artery infarction which can robustly be detected using whole-brain CT perfusion, (ii) its occurrence is influenced by location and degree of the supratentorial perfusion reduction rather than infarct volume (iii) other clinical factors (age, sex and time from symptom onset) did not affect the occurrence of crossed cerebellar diaschisis.
authors.affiliation: Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, Munich, Germany.
authors.forename: Wieland H
authors.initials: WH
authors.lastname: Sommer
authors.affiliation: Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, Munich, Germany.
authors.forename: Christine
authors.initials: C
authors.lastname: Bollwein
authors.affiliation: Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, Munich, Germany.
authors.forename: Kolja M
authors.initials: KM
authors.lastname: Thierfelder
authors.affiliation: Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, Munich, Germany.
authors.forename: Alena
authors.initials: A
authors.lastname: Baumann
authors.affiliation: Department of Neuroradiology, Ludwig-Maximilians-University Hospital Munich, Munich, Germany.
authors.forename: Hendrik
authors.initials: H
authors.lastname: Janssen
authors.affiliation: Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, Munich, Germany.
authors.forename: Birgit
authors.initials: B
authors.lastname: Ertl-Wagner
authors.affiliation: Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, Munich, Germany.
authors.forename: Maximilian F
authors.initials: MF
authors.lastname: Reiser
authors.affiliation: Department of Neurology, Ludwig-Maximilians-University Hospital Munich, Munich, Germany.
authors.forename: Annika
authors.initials: A
authors.lastname: Plate
authors.affiliation: Department of Neurology, Ludwig-Maximilians-University Hospital Munich, Munich, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Straube
authors.affiliation: Department of Neurology, Ludwig-Maximilians-University Hospital Munich, Munich, Germany Louisa.vonBaumgarten@med.uni-muenchen.de.
authors.forename: Louisa
authors.initials: L
authors.lastname: von Baumgarten
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000375:Aging; D016022:Case-Control Studies; D002531:Cerebellum / Q000098:blood supply / Q000473:pathology* / Q000503:physiopathology; D002560:Cerebrovascular Circulation; D015331:Cohort Studies; D005260:Female; D005625:Frontal Lobe / Q000098:blood supply; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000453:epidemiology / Q000473:pathology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D012727:Sex Characteristics; D013788:Thalamus / Q000098:blood supply; D014057:Tomography, X-Ray Computed
keywords: CT perfusion imaging; Crossed cerebellar diaschisis; MCA infarction; ischemic stroke