Clinical Prognosis Correlated with Hemispheric Blood Flow in Cerebral Infarction

In 44 patients with acute unilateral cerebral infarction, there was reduction of hemispheric blood flow (HBF) and metabolism in the healthy hemisphere (phenomenon of diaschisis) as well as in the diseased hemisphere in patients in all age groups (30 to 70 years of age). In patients with symptoms present for three weeks or longer, the decrease in HBF in the healthy hemisphere was less than during the acute stage of infarction. The HBF in the healthy hemisphere of the younger patients approached normal values months or years after the stroke but remained reduced in older patients, probably reflecting diffuse as well as focal cerebrovascular disease. When the severity and outcome of the neurological deficit was correlated with the blood flow and metabolism of the diseased hemisphere, it was apparent that HBF in patients with transient ischemic attacks and more prolonged but reversible neurological deficit was greater than in those who had sustained severe, permanent neurological deficit.