Crossed cerebellar diaschisis - Rasmussen encephalitis

Case contributed by Ayaz Hidayatov


Known history of Rasmussen encephalitis diagnosed 10 years ago presented with seizures. The patient was born full term and had a normal childhood until the age of 10 when seizures started. There is a moderate left hemiparesis. No cognitive impairment.

Patient Data

Age: 25 years
Gender: Female

MR demonstrates diffuse right cerebral hemiatrophy with encephalomalacia and gliotic changes involving the whole hemisphere. There is also severe ex vacuo dilatation of the right lateral ventricle. Reduction in volume of the ipsilateral cerebral peduncle due to Wallerian degeneration.

There is also contralateral cerebellar hemiatrophy and gliosis with atrophy of the left middle cerebellar peduncle was noted.

Case Discussion

Diaschisis refers to a depression of metabolism affecting the cerebellar hemisphere, as a result of a contralateral supratentorial damage caused by interruption of cortico-ponto-cerebellar tracts.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.