De Reuck J, Decoo D, Lemahieu I, Strijckmans K, Goethals P, Van Maele G
Department of Neurology, University Hospital, Ghent, Belgium.
J Neurol Sci. 1995 Dec;134(1-2):130-5. doi: 10.1016/0022-510x(95)00229-2.
The significance of ipsilateral thalamic diaschisis (ITD) among patients with chronic, stable middle cerebral artery (MCA) infarcts was investigated. Twenty eight subjects with chronic MCA infarction and twenty two normal controls were studied with positron emission tomography (PET), using the steady state technique with 15O. Stroke patients were subdivided into a group with ITD (n = 12) and a group without ITD (n = 16). Patients with ITD had greater decreases of regional blood flow (rCBF) and oxygen consumption (rCMRO2) in the infarcted MCA territory, compared to MCA infarction without ITD. The neurological deficits at the time of PET scanning were similar between both groups. Extent of infarction by CT brain scan appeared more predominant in peri-insular regions of patients with ITD, while in non diaschisis patients infarcts were more widely distributed throughout the MCA territories. Occurrence of ITD and of crossed cerebellar diaschisis (CCD) did not correlate. Occurrence of ITD seems to be linked to diffuse reductions of blood flow and oxygen metabolism in cortical territories of the MCA. Mechanisms of ITD were different from those of CCD.
研究了慢性、稳定的大脑中动脉（MCA）梗死患者同侧丘脑远隔性损害（ITD）的意义。对28例慢性MCA梗死患者和22名正常对照者采用15O稳态技术进行正电子发射断层扫描（PET）研究。卒中患者被分为有ITD组（n = 12）和无ITD组（n = 16）。与无ITD的MCA梗死患者相比，有ITD的患者梗死的MCA区域局部脑血流量（rCBF）和氧耗量（rCMRO2）下降更明显。PET扫描时两组的神经功能缺损相似。CT脑扫描显示，ITD患者梗死灶在岛周区域更为突出，而非远隔性损害患者的梗死灶在整个MCA区域分布更广泛。ITD的发生与交叉性小脑远隔性损害（CCD）的发生无关。ITD的发生似乎与MCA皮质区域血流和氧代谢的弥漫性降低有关。ITD的机制与CCD不同。
