脳幹梗塞によるｄｉａｓｃｈｉｓｉｓ

DOI 被引用文献1件 参考文献20件

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  • Diaschisis in brain stem infarction.

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We investigated 17 patients suffering from single unilateral brain stem infarction (in the midbrain in 2 patients, in the pons in 9, and in the medulla in 6) to elucidate their remote cerebral and cerebellar blood flow changes. Regional cerebral blood flow was evaluated semiquantitatively by SPECT and 99mTc-HMPAO, and the asymmetry index was calculated in certain regions of the cerebral cortex and cerebellum. A decreased cerebral blood flow was noted in 7 patients with infarction involving the dorsal brain stem, ipsilateral hypoperfusion occurred in patients with lesions situated rostrally to the upper pons, and contralateral hypoperfusion occurred in patients with lesions situated caudally to the upper pons, due probably to interruption of the cerebellothalamocortical pathways or damage to the fibers of the ascending reticular activating system. A decreased cerebellar blood flow was noted in 6 patients with infarction involving the ventral brain stem or cerebellar peduncle, contralateral hypoperfision occurred in patients with lesions situated rostrally to the middle or lower pontine basis, and ipsilaleral hypoper-fusion occurred in patients with lesions in the meddula, suggesting damage to the corticoponetocerbellar or olivocerebellar pathways. Although cerebral hypoperfusion evident only within 1 or 2 months after stroke cerebellar hypoperfusion was commonly demonstrated at several months after stroke. Remote cerebral and cerebellar blood flow reductions are commonly observed in brain sterm infarction, probably associated with lesions of the projectional fiber tracts.

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  • 脳卒中

    脳卒中 20 (3), 312-317, 1998

    一般社団法人 日本脳卒中学会

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