Crossed cerebellar diaschisis on CT perfusion in large vessel occlusion stroke: early predictors and clinical relevance in the hyperacute phase.

Crossed cerebellar diaschisis (CCD) was identified by CT perfusion in a high proportion of anterior circulation LVO stroke patients.

• Perfusion alterations consistent with CCD were identified in 216 of 256 patients (84.4%).
• CCD was assessed through qualitative analysis of CTP perfusion maps.
• The study population consisted of 256 consecutive patients with anterior circulation LVO ischemic stroke who underwent CTP.

Female sex was independently associated with the presence of CCD in multivariable analysis.

• Female sex was a statistically significant independent predictor of CCD (p = 0.026).
• This association was identified through multivariate logistic regression analysis.
• Both univariate and multivariate logistic regression analyses were performed to identify factors associated with CCD presence.

Greater supratentorial hypoperfused volume on mean transit time (MTT) maps was independently associated with the presence of CCD.

• Larger supratentorial hypoperfused volumes on MTT maps were a statistically significant independent predictor of CCD (p = 0.005).
• This association was identified in multivariable logistic regression analysis.
• MTT maps were used to quantify the supratentorial hypoperfused volume in CTP imaging.

CCD was associated with unfavorable functional outcome at 3 months in univariate but not multivariable analysis.

• CCD was associated with a higher prevalence of unfavorable functional outcome at 3 months (mRS 3–6) in univariate analysis.
• CCD was not an independent predictor of outcome in multivariable analysis.
• Functional outcome was assessed using the modified Rankin Scale (mRS) at 3 months, with unfavorable outcome defined as mRS 3–6.