Crossed Cerebellar Diaschisis in Acute Isolated Thalamic Infarction Detected by Dynamic Susceptibility Contrast Perfusion MRI
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{"title"=>"Crossed cerebellar diaschisis in acute isolated thalamic infarction detected by dynamic susceptibility contrast perfusion MRI", "type"=>"journal", "authors"=>[{"first_name"=>"Alex", "last_name"=>"Förster", "scopus_author_id"=>"24068789000"}, {"first_name"=>"Hans U.", "last_name"=>"Kerl", "scopus_author_id"=>"53264212800"}, {"first_name"=>"Johannes", "last_name"=>"Goerlitz", "scopus_author_id"=>"56058688800"}, {"first_name"=>"Holger", "last_name"=>"Wenz", "scopus_author_id"=>"55524148900"}, {"first_name"=>"Christoph", "last_name"=>"Groden", "scopus_author_id"=>"6603760706"}], "year"=>2014, "source"=>"PLoS ONE", "identifiers"=>{"pui"=>"372535150", "doi"=>"10.1371/journal.pone.0088044", "pmid"=>"24505372", "issn"=>"19326203", "scopus"=>"2-s2.0-84895526572", "sgr"=>"84895526572"}, "id"=>"c3f5b074-9c62-37ec-bb41-9ee545818849", "abstract"=>"PURPOSE: Crossed cerebellar diaschisis (CCD) is a state of neural depression caused by loss of connections to injured neural structures remote from the cerebellum usually evaluated by positron emission tomography. Recently it has been shown that dynamic susceptibility contrast perfusion weighted MRI (PWI) may also be feasible to detect the phenomenon. In this study we aimed to assess the frequency of CCD on PWI in patients with acute thalamic infarction.\\n\\nMETHODS: From a MRI report database we identified patients with acute isolated thalamic infarction. Contralateral cerebellar hypoperfusion was identified by inspection of time to peak (TTP) maps and evaluated quantitatively on TTP, mean transit time (MTT), cerebral blood flow and volume (CBF, CBV) maps. A competing cerebellar pathology or an underlying vascular pathology were excluded.\\n\\nRESULTS: A total of 39 patients was included. Common symptoms were hemiparesis (53.8%), hemihypaesthesia (38.5%), dysarthria (30.8%), aphasia (17.9%), and ataxia (15.4%). In 9 patients (23.1%) PWI showed hypoperfusion in the contralateral cerebellar hemisphere. All of these had lesions in the territory of the tuberothalamic, paramedian, or inferolateral arteries. Dysarthria was observed more frequently in patients with CCD (6/9 vs. 6/30; OR 8.00; 95%CI 1.54-41.64, p = 0.01). In patients with CCD, the median ischemic lesion volume on DWI (0.91 cm³), IQR 0.49-1.54 cm³) was larger compared to patients with unremarkable PWI (0.51 cm³, IQR 0.32-0.74, p = 0.05). The most pronounced changes were found in CBF (0.94±0.11) and MTT (1.06±0.13) signal ratios, followed by TTP (1.05±0.02).\\n\\nCONCLUSIONS: Multimodal MRI demonstrates CCD in about 20% of acute isolated thalamic infarction patients. Lesion size seems to be a relevant factor in its pathophysiology.", "link"=>"http://www.mendeley.com/research/crossed-cerebellar-diaschisis-acute-isolated-thalamic-infarction-detected-dynamic-susceptibility-con", "reader_count"=>28, "reader_count_by_academic_status"=>{"Unspecified"=>2, "Professor > Associate Professor"=>2, "Student > Doctoral Student"=>5, "Researcher"=>5, "Student > Ph. D. Student"=>3, "Student > Postgraduate"=>4, "Student > Master"=>4, "Student > Bachelor"=>2, "Lecturer"=>1}, "reader_count_by_user_role"=>{"Unspecified"=>2, "Professor > Associate Professor"=>2, "Student > Doctoral Student"=>5, "Researcher"=>5, "Student > Ph. D. Student"=>3, "Student > Postgraduate"=>4, "Student > Master"=>4, "Student > Bachelor"=>2, "Lecturer"=>1}, "reader_count_by_subject_area"=>{"Unspecified"=>2, "Engineering"=>1, "Medicine and Dentistry"=>14, "Agricultural and Biological Sciences"=>2, "Neuroscience"=>3, "Psychology"=>5, "Linguistics"=>1}, "reader_count_by_subdiscipline"=>{"Engineering"=>{"Engineering"=>1}, "Medicine and Dentistry"=>{"Medicine and Dentistry"=>14}, "Neuroscience"=>{"Neuroscience"=>3}, "Psychology"=>{"Psychology"=>5}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>2}, "Linguistics"=>{"Linguistics"=>1}, "Unspecified"=>{"Unspecified"=>2}}, "reader_count_by_country"=>{"United States"=>1}, "group_count"=>1}

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Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/1377349"], "description"=>"<p>1. A 75-year-old female patient with reduced vigilance, dysarthria, and right-sided hemihypaesthesia: <i>A</i> Trace diffusion-weighted image shows an acute ischemic lesion (arrow) in the territory of the left tuberothalamic artery with <i>B</i> matching hypoperfusion (arrow) on the time to peak (TTP) map. <i>C</i> In the cerebellum trace DWI is unremarkable while <i>D</i> TTP demonstrates hypoperfusion in the contralteral cerebellar hemisphere. 2. A 65-year-old female patient with right-sided hemiparesis: <i>E</i> Trace DWI shows an acute ischemic lesion (arrow) in the territory of the left paramedian artery with <i>F</i> minor hypoperfusion (arrow) on TTP. <i>G</i> In the cerebellum trace DWI is unremarkable while <i>H</i> TTP demonstrates hypoperfusion in the contralateral cerebellar hemisphere.</p>", "links"=>[], "tags"=>["Anatomy and physiology", "Neurological system", "Central nervous system", "Clinical research design", "Retrospective studies", "neurology", "Cerebrovascular diseases", "Ischemic stroke", "Cerebellar disorders", "neuroimaging", "radiology", "Diagnostic radiology", "Magnetic resonance imaging", "examples", "crossed", "cerebellar"], "article_id"=>927073, "categories"=>["Medicine"], "users"=>["Alex Forster", "Hans U. Kerl", "Johannes Goerlitz", "Holger Wenz", "Christoph Groden"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0088044.g001", "stats"=>{"downloads"=>2, "page_views"=>56, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Two_examples_of_crossed_cerebellar_diaschisis_/927073", "title"=>"Two examples of crossed cerebellar diaschisis.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-02-05 03:25:19"}
  • {"files"=>["https://ndownloader.figshare.com/files/1377350"], "description"=>"<p>Demographic characteristics, ischemic lesion size and localization on diffusion-weighted images (DWI) as well as frequency of clinical symptoms in isolated thalamic infarction patients with crossed cerebellar diaschisis (CCD) and normal PWI.</p>", "links"=>[], "tags"=>["Anatomy and physiology", "Neurological system", "Central nervous system", "Clinical research design", "Retrospective studies", "neurology", "Cerebrovascular diseases", "Ischemic stroke", "Cerebellar disorders", "neuroimaging", "radiology", "Diagnostic radiology", "Magnetic resonance imaging", "ischemic", "lesion", "localization", "diffusion-weighted", "images", "symptoms", "thalamic", "infarction", "patients", "crossed", "cerebellar", "diaschisis"], "article_id"=>927074, "categories"=>["Medicine"], "users"=>["Alex Forster", "Hans U. Kerl", "Johannes Goerlitz", "Holger Wenz", "Christoph Groden"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0088044.t001", "stats"=>{"downloads"=>3, "page_views"=>22, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Demographic_characteristics_ischemic_lesion_size_and_localization_on_diffusion_weighted_images_DWI_as_well_as_frequency_of_clinical_symptoms_in_isolated_thalamic_infarction_patients_with_crossed_cerebellar_diaschisis_CCD_and_normal_PWI_/927074", "title"=>"Demographic characteristics, ischemic lesion size and localization on diffusion-weighted images (DWI) as well as frequency of clinical symptoms in isolated thalamic infarction patients with crossed cerebellar diaschisis (CCD) and normal PWI.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-02-05 03:25:19"}

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Relative Metric

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