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AJNR - American Journal of Neuroradiology

Published ahead of print on February 4, 2009
doi: 10.3174/ajnr.A1435

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Crossed Cerebellar Diaschisis in Acute Stroke Detected by Dynamic Susceptibility Contrast MR Perfusion Imaging

D.D.M. Lin^a, J.T. Kleinman^b, R.J. Wityk^b, R.F. Gottesman^b, A.E. Hillis^b, A.W. Lee^b and P.B. Barker^a

^a Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Md
^b Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Md

View larger version (58K): [in this window] [in a new window]   Fig 1. Three cases (A, B, and C) of infarct affecting the dominant cerebral hemisphere associated with contralateral cerebellar hypoperfusion. PWI maps according to TTP show supratentorial and contralateral cerebellar hypoperfusion relative to the opposite hemisphere (first and third rows). DWI (second and fourth rows) shows acute infarct co-localized with supratentorial perfusion abnormality. The co-localized cerebellum (fourth row) shows no evidence of infarct in the region of the hypoperfusion.

View larger version (37K): [in this window] [in a new window]   Fig 2. R2* (= –ln(S/S0)/TE) versus time curves of case C from Fig 1 in the cerebrum and cerebellum show a shift of bolus arrival time to the right side (ie, prolonged TTP) in the hypoperfused brain with acute infarct, and in the contralateral cerebellum without evidence of ischemia.