Presentation
Vehicle accident 15 years ago; epileptic seizures.
Patient Data
Post-surgery encephalomalacia in the left frontal and parietal lobes and parietal encephalocele extruding throught the bone defect.
A volume reduction of the ipsilateral cerebral peduncle suggested Wallerian degeneration and a decreased volume of the contralateral cerebellar hemisphere.
Case Discussion
Crossed cerebellar diaschisis is caused by hypometabolism of the cerebellar hemisphere (hence, volume reduction) due to supratentorial lesions and cortico-ponto-cerebellar pathway interruption.
CT isn't a modality of choice; MRI and functional studies are preferred.