기저핵 출혈에 의한 교차 소뇌 해리 현상

Abstract

Purpose : The purpose of this study was to evaluate the phenomenon of diaschisis in the cerebellum and cerebral cortex in patients with pure basal ganglia hemorrhage using cerebral blood flow SPECT. Materials and Methods : Twelve patients with pure basal ganglia hemorrhage were studied with Tc-99m ECD brain SPECT Asymmetric index (AI) was calculated in the cerebellum and cerebral cortical regions as ｜CR-CL｜ /(CR-CL)×200, where CR and CL are the mean reconstructed counts for the right and left ROIs, respectively. Hypoperfusion was considered to be present when AI was greater than mean＋2SD of 20 control subjects. Results : Mean AI of the cerebellum and cerebral cortical regions in patients with pure basal ganglia hemorrhage was significantly higher than normal controls (p<0.05): Cerebellum (18.68±8.94 vs 4.35±0.94, mean±SD), thalamus (31.91±10.61 vs 2.57±1.45), basal ganglia (35.94±16.15 vs 4.34±2.08), parietal (18.94±10.69 vs 3.24±0.87), frontal (13.60±10.8 vs 4.02±2.04) and temporal cortex (18.92±11.95 vs 5.13±1.69). Ten of the 12 patients had significant hypoperfusion in the contralateral cerebellum. Hypoperfusion was also shown in the ipsilateral thalamus (n= 12), ipsilateral parietal (n= 12), frontal (n=6) and temporal cortex (n=10). Conclusion : Crossed cerebellar diaschisis (CCD) and cortical diaschisis may frequently occur in patients with pure basal ganglia hemorrhage, suggesting that CCD can develop without the interruption of corticopontocerebellar pathway.