
No Diaschisis After Stroke-Reply
Ross L. Levine, MD;
Jeffrey A. Dobkin, MD
Positron Emission Center University of Wisconsin Madison, WI 53705
Arch Neurol. 1990;47(6):621.
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In Reply.
—Dr Stolzberg correctly points out that the mean cerebral blood flow values are lowered throughout all patient groups in our study.1 We clearly state this throughout our article and illustrate it using appropriate figures. We do not argue with Dr Stolzberg's contention that "stroke is a disease of the microcirculation" as we clearly point out that our finding of a strong correlation between ipsilateral and contralateral cerebral blood flow invokes either a mechanism of diaschisis or a diffuse effect of yet unidentified microcirculatory disease.1 We do not discuss "plumbing" defects.
We have already suggested in the concluding paragraph that the further study of cerebral blood flow following stroke will need to take into account such factors as exact age-matched controls, transient ischemia attack control subjects rather than normal subjects, unilateral event and unilateral diseased subjects, and prospective data collection. We accept that contralateral cerebral blood flow
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