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Parieto-cerebellar Loop Impairment in Ataxic Hemiparesis: Proposed Pathophysiology Based on an Analysis of Cerebral Blood Flow

Published online by Cambridge University Press:  18 September 2015

Ezzedine Attig
Ezzedine Attig*
Affiliation:
Department of Neurology, Hôtel-Dieu Hospital, Montreal
*
Department of Neurology, Hôtel-Dieu Hospital, 3840 St. Urbain, Montreal, Quebec, Canada H2W 1T8
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Abstract:

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Sixteen stroke patients suffering from ataxic hemiparesis syndrome were studied with regional cerebral blood flow measured by 133-Xenon inhalation technique (12 patients) and by SPECT (HMPAO) (9 patients). The causative lesions (hematoma in 7 and infarct in 9), unilateral in 15 patients and bilateral in 1, were located in the posterior two-thirds of the corona radiata, thalamocapsular and subthalamus regions, or cerebral peduncle. Ataxia of the cerebellar type was unilateral in 15 patients and bilateral in 1 with similar, deep, bilateral causative lesions. Four patients presented some characteristics of proprioceptive ataxia (mixed ataxia). Associated cognitive disturbances were present in 9 patients and absent in 7. Eleven of the 12 subjects studied by 133-Xenon inhalation technique showed limited centro-parietal hypoperfusion, mainly in the inferior parietal lobule, ipsilateral to the causative lesion and bilaterally in the patient with bilateral lesions and ataxia. Ipsilateral hypoperfusion was confirmed in 7/9 patients studied by SPECT, which also demonstrated contralateral cerebellar hypoperfusion in 4 patients. These findings suggest that ataxic hemiparesis syndrome results from functional depression (diaschisis) consequent to the interruption at many levels of an “inferior parietal associative cortex - cerebellar anterior lobe” circuit.

Type
Articles
Information
Canadian Journal of Neurological Sciences , Volume 21 , Issue 1 , February 1994 , pp. 15 - 23
Copyright
Copyright © Canadian Neurological Sciences Federation 1994

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