Ataxic Hemiparesis From Strategic Frontal White Matter Infarction With Crossed Cerebellar Diaschisis

Flint, Alexander C.; Naley, Mary Alice C.; Wright, Clinton B.

doi:10.1161/01.str.0000195179.93268.e2

Cited by 31 publications

(15 citation statements)

References 10 publications

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“…Recently, ataxia associated with capsular infarct has generally been explained by crossed cerebellar diaschisis [10,11,12]. However, in our present study, crossed cerebellar diaschisis was seen not only in the ataxic hemiparesis group but also in the pure motor hemiparesis group.…”

Section: Discussioncontrasting

confidence: 82%

“…Damage to the cortico-ponto-cerebellar pathway causes crossed cerebellar diaschisis, a functional depression in the contralateral cerebellum [8,9]. This crossed cerebellar diaschisis is currently thought to be the most frequent cause of the ataxia that follows capsular infarct; some recent studies have indicated the presence of crossed cerebellar diaschisis in patients with capsular infarct associated with ataxia [10,11,12]. However, these studies were based either on a small number of cases or even a single case.…”

Section: Introductionmentioning

confidence: 99%

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The Mechanism of Ipsilateral Ataxia in Lacunar Hemiparesis: SPECT Perfusion Imaging

Yamamoto¹,

Johkura²,

Nakae³

et al. 2014

Eur Neurol

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Background and Purpose: Although ataxic hemiparesis is a common lacunar syndrome, the precise mechanism underlying hemiataxia is not clear. We attempted to identify ataxia-related, cerebral blood flow changes in patients presenting with ataxic hemiparesis after acute capsular infarct. Methods: We used 99mTc-ECD brain perfusion single-photon emission computed tomography to evaluate regional cerebral blood flow in 12 patients with ataxic hemiparesis caused by capsular infarct, and we compared the regional blood flow of these patients with that of 11 patients with pure motor hemiparesis caused by similar lesions. Results: The ipsilateral red nucleus blood flow was significantly decreased in the ataxic hemiparesis patients, whereas the ipsilateral red nucleus blood flow was increased in the pure motor hemiparesis patients. Crossed cerebellar diaschisis (decreased contralateral cerebellar blood flow) was seen in ataxic hemiparesis patients; similarly, it was seen in pure motor hemiparesis patients. Conclusions: Our findings suggest that ataxia in hemiparetic patients with capsular infarct can be caused by ipsilateral red nucleus dysfunction secondary to cortico-rubral pathway disruption at the internal capsule. i 2014 S. Karger AG, Basel

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Section: Discussioncontrasting

confidence: 82%

Section: Introductionmentioning

confidence: 99%

The Mechanism of Ipsilateral Ataxia in Lacunar Hemiparesis: SPECT Perfusion Imaging

Yamamoto¹,

Johkura²,

Nakae³

et al. 2014

Eur Neurol

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“…A recent report showed that three patients with AH caused by subcortical white matter lesions showed CCD 21. Two of our three patients who underwent SPECT did not show CCD, evidence that it is not always required for the occurrence of cerebral cortical or subcortical AH.…”

Section: Discussionsupporting

confidence: 50%

“…Some studies have reported the possibility of CCD in AH patients 13 18 – 21. A recent report showed that three patients with AH caused by subcortical white matter lesions showed CCD 21.…”

Section: Discussionmentioning

confidence: 99%

Diffusion weighted imaging in ataxic hemiparesis

Hiraga

Uzawa

Kamitsukasa

2007

Journal of Neurology, Neurosurgery & Psychiatry

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Objective: Ataxic hemiparesis (AH) is a well recognised lacunar syndrome involving homolateral ataxia with accompanying corticospinal tract impairment. Most previous studies of lesion location in AH did not use diffusion weighted MRI (DW MRI). The purpose of this study was to use DW MRI to evaluate the radiological correlation in patients presenting with AH. Methods: Retrospectively, we studied 29 patients with AH using DW MRI. Results: All patients were scanned within 4 days of onset. Acute infarction was identified in 28 of 29 (97%) patients. A single lesion was identified in 26 patients: pons (n = 8), internal capsule (n = 6), corona radiata (n = 2), distended internal capsule from corona radiate (n = 7), frontal subcortical area (n = 1) and precentral with or without postcentral gyrus (n = 2). Two lesions were found in two patients: in the pons and corpus callosum of one patient, and in the corona radiata and subcortical white matter of the other. Conclusions: AH is mainly caused by pontine or internal capsule/corona radiata lesions. It also occurs in the precentral gyrus, including the precentral knob, with or without postcentral gyrus lesions. Fibres of the fronto-ponto-cerebellar system may originate from the frontal cortex, including the precentral gyrus, probably near the pyramidal tract. Damage at this location may cause AH.

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“…20,39,40 Although CCD is reported most often in association with large cerebral hemispheric infarcts, 40,41 small infarcts could cause CCD. 39 A few previous studies reported that infarct volume contributes to the development of CCD, but the sample sizes (n ϭ 20 and 17, respectively) were too small. 11,20 In addition, the patient populations in these previous studies were all in the acute stages of stroke.…”

Section: Discussionmentioning

confidence: 99%

Correlation of Asymmetry Indices Measured by Arterial Spin-Labeling MR Imaging and SPECT in Patients with Crossed Cerebellar Diaschisis

Kang

Sohn

Kim

et al. 2015

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:Crossed cerebellar diaschisis, not only a secondary result of supratentorial infarction but also an indicator of clinical outcomes, has frequently been reported on PET and SPECT but has been rarely described with arterial spin-labeling MR imaging. The purpose of this study was to determine the ability of arterial spin-labeling MR imaging to evaluate crossed cerebellar diaschisis compared with that of SPECT. To our knowledge, this is the first study to validate arterial spin-labeling in crossed cerebellar diaschisis by using SPECT as a reference standard.

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Ataxic Hemiparesis From Strategic Frontal White Matter Infarction With Crossed Cerebellar Diaschisis

Cited by 31 publications

References 10 publications

The Mechanism of Ipsilateral Ataxia in Lacunar Hemiparesis: SPECT Perfusion Imaging

The Mechanism of Ipsilateral Ataxia in Lacunar Hemiparesis: SPECT Perfusion Imaging

Diffusion weighted imaging in ataxic hemiparesis

Correlation of Asymmetry Indices Measured by Arterial Spin-Labeling MR Imaging and SPECT in Patients with Crossed Cerebellar Diaschisis

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