[Diaschisis in right putaminal hemorrhage: correlation with the degree of the extension to the internal capsule and the volume of hematoma].

Local cerebral lesions may cause depression of function in remote areas of the brain presumably by a transneural mechanism. This has been called "diaschisis". In the present study, regional brain blood flow in hypertensive right putaminal hemorrhage was studied in 33 patients (mean age, 55 year; 22 men, 11 women) to investigate the relationship between the degree in damage of the original lesions and "diaschisis". The hematoma was treated conservatively in 8 patients, aspirated stereotaxically in 9 patients, and evacuated through craniotomy in 16 patients. The regional blood flow in bilateral motor cortices and bilateral cerebellar hemispheres was measured by a single photon emission CT with N-isopropyl-p- [123 I] iodo-amphetamine intravenous injection, and was evaluated by the RI count on early image/the decay-corrected RI count on delayed image (E/D). The regional brain blood flow was measured for 29 to 35 days from the onset. There was a negative correlation between the degree of the extension to the internal capsule and the regional blood flow of the right motor cortex and the bilateral cerebellar hemispheres. There was also a negative correlation between the volume of the hematoma and the regional blood flow of the right motor cortex and the bilateral cerebellar hemispheres. The regional blood flow of the left motor cortex correlated with neither the degree of the extension to the internal capsule nor the volume of the hematoma. On the other hand, there was a positive correlation in the regional blood flow between the bilateral motor cortices.(ABSTRACT TRUNCATED AT 250 WORDS)