Crossed cerebellar diaschisis

Case contributed by Dr Mauricio Macagnan

Presentation

Patient with a history of cerebral infarction. Currently has motor symptoms and limited mobility .

Patient Data

Age: 67
Gender: Female
Modality: MRI

Areas with low signal SWI compatible with hemorrhagic sequelae ( hemosiderin ), located in the left corona radiata and the insula, external capsule and lenticular nucleus, beyond the right amygdala and in the white matter of the temporal lobes .

Atrophy of the right cerebellar hemisphere, possibly related to crossed cerebellar diaschisis secondary to supratentorial injury.

Noareas of ischemic stroke in evolution on the DWI weighted sequences.

Modality: Diagram

The diagram shows cortico-ponto-cerebellar pathway, which due to supratentorial infarction has stopped and chronically determines contralateral cerebellar atrophy.

Case Discussion

In this condition , there is a decrease in functional activity and metabolism in the cerebellum contralateral supratentorial lesion.  This mechanism has been observed in cerebral ischemia patients , supratentorial tumors , epilepsy , encephalitis and some resulting in the disruption of the cortico-ponto-cerebellar pathway.

Functional studies through the use of CT , MRI and CT perfusion help the diagnosis.

This case was kindly provided by Dr Rodrigo Dias Duarte.

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Case Information

rID: 47317
Case created: 11th Aug 2016
Last edited: 10th Sep 2016
Inclusion in quiz mode: Included

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