Cerebellar blood flow and metabolism in cerebral hemisphere infarction

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Abstract
Positron emission tomography was used to study the effect of supratentorial infarction on cerebellar metabolic rate for oxygen and cerebellar blood flow. In a control group of patients, the mean cerebellar metabolic rate for oxygen was 2.97 ± 0.11 (standard error of the mean [SEM]) ml−1 · min−1 · hg−1 and mean cerebellar blood flow was 41.1 ± 1.5 ml · min−1 · hg−1. No significant right‐left asymmetry in either cerebellar metabolic rate for oxygen or cerebellar blood flow was noted. Patients with frontal lobe infarction showed 16.8 ± 1.8% (cerebellar metabolic rate for oxygen) and 19.6 ± 2.1% (cerebellar blood flow) differences between cerebellar hemispheres, with the hemisphere contralateral to the cerebral infarction having the lower values. These differences were highly significant (p < 0.001). In addition, cerebellar blood flow and cerebellar metabolic rate for oxygen were significantly decreased in the ipsilateral cerebellar hemisphere (metabolism: 2.13 ± 0.19 ml · min−1 · hg−1; p < 0.002; blood flow: 35.2 ± 2.4 ml · min−1 · hg−1; p < 0.05). Patients with parietooccipital infarction also showed a significant bilateral decrease in cerebellar metabolic rate for oxygen (2.43 ± 0.11 ml · min−1 · hg−1) and cerebellar blood flow (34.6 ± 2.5 ml · min−1 · hg−1) relative to control subjects, but no significant cerebellar asymmetry. Our findings demonstrate a general depression of cerebellar blood flow and metabolism from cerebral hemisphere infarction unrelated to the site of infarction as well as a specific depression occurring contralateral to infarction involving the frontal lobe. These are among the first quantitative data concerning regional cerebellar metabolic rates for oxygen and cerebellar blood flow in humans.