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Crossed cerebellar diaschisis

Case contributed by Ryan Thibodeau
Diagnosis certain

Presentation

Altered mental status. Reported seizure. Evaluate for underlying intracranial abnormality.

Patient Data

Age: 45 years
Gender: Male

There are postsurgical changes related to previous right frontotemporal parietal craniotomy. Encephalomalacia is noted within the frontal lobe, basal ganglia, and insula. A site of dystrophic calcification as well as metallic postoperative changes are present as well. There is compensatory enlargement of the right lateral ventricular system. There is atrophy of the peripheral aspect of the left cerebellar hemisphere.

There is thin extra-axial hyperdensity along the right frontal cerebral convexity.

Case Discussion

This is a case of crossed cerebellar diaschisis. The patient has a history of history of multiple traumas including traumatic brain injury from a motor vehicle accident at age 15 and a gunshot wound to the head at age 16. The patient has evidence of right cerebral encephalomalacia with resultant left hemiplegia and seizures. The patient arrived as a transfer from an outside hospital where crossed cerebellar diaschisis was incidentally noted.

Co-author:
Guy Gechtman

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