Fact-sheet: Crossed cerebellar diaschisis
Updated on 09/16/2020 at 12:22 PM
View all RADEOS cases associated with this fact-sheet
Definition
Diaschisis:
- interruption of the activity of a group of neurons remote from the injured area,
- sharing anatomic connections and physiologic links with it,
- either direct or indirect.
Crossed cerebellar diaschisis:
- described in stroke, traumatic brain injury, status epilepticus, migraine with aura, Rasmussen encephalitis...
- due to involvement of the cortico-ponto-cerebellar and dentato-rubro-thalamic tracts,
- involvement of glutamatergic neurotransmitters?
MRI
Abnormalities visible on the following sequences:
- T2, T2 FLAIR, diffusion-weighted imaging, perfusion imaging.
Look for:
- the causative hemispheric lesion
- involvement of a cerebellar hemisphere, with the cerebellar gray nuclei appearing hyperintense on T2/FLAIR, hyperintense on diffusion-weighted imaging with restricted ADC.
- often associated with involvement of the thalamus contralateral to the hemispheric lesion.
Nuclear medicine
FDG PET/CT: hypometabolism of the affected cerebellar hemisphere.
Management
Most of the time, the abnormalities are reversible.
Depends on the causative lesion: may progress to atrophy (e.g., Rasmussen encephalitis).