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Crossed Cerebellar Diaschisis Due To Intracranial Hematoma in Basal Ganglia or Thalamus

 Joon Seok Lim  ;  Young Hoon Ryu  ;  Byung Moon Kim  ;  Jong Doo Lee 
 JOURNAL OF NUCLEAR MEDICINE, Vol.39(12) : 2044-2047, 1998 
Journal Title
Issue Date
Adult ; Aged ; Basal Ganglia Diseases/complications* ; Basal Ganglia Diseases/diagnostic imaging ; Brain/blood supply ; Cerebellar Diseases/diagnostic imaging* ; Cerebellar Diseases/etiology* ; Cerebral Hemorrhage/complications* ; Cerebral Hemorrhage/diagnostic imaging* ; Cerebrovascular Circulation* ; Cysteine/analogs & derivatives ; Female ; Functional Laterality ; Humans ; Male ; Middle Aged ; Organotechnetium Compounds ; Radiopharmaceuticals ; Regional Blood Flow ; Thalamic Diseases/complications* ; Thalamic Diseases/diagnostic imaging ; Tomography, Emission-Computed, Single-Photon
The purpose of our study was to evaluate the remote effects on the cerebellum and cerebral cortex from subcortical hematoma without cortical structural abnormality. METHODS: Our study included 23 patients with hematoma, strictly confined either to the basal ganglia (n = 12) or thalamus (n = 11) without cortical abnormality on CT or MRI. Twenty psychiatric patients without structural abnormality on MRI were selected as control subjects. Technetium-ethyl cysteinate dimer brain SPECT was performed in patients and control subjects. Regional cerebral blood flow (rCBF) was visually and semiquantitatively assessed. Asymmetry index (AI) was determined using data from regions of interest at the basal ganglia, thalamus, cerebellum, frontal, parietal and temporal cortex to support the semiquantitative analysis. The criteria for defining hypoperfusion that reflected diaschisis was based on an AI > the mean + 2 s.d. of AI in control subjects. RESULTS: In the basal ganglia hematoma, rCBF was reduced significantly in the contralateral cerebellum (10/12), ipsilateral thalamus (12/12), ipsilateral frontal (6/12), parietal (12/12) and temporal cortex (10/12). As for thalamic hematoma, significantly reduced perfusion was seen in the contralateral cerebellum (10/11), ipsilateral basal ganglia (7/11), ipsilateral frontal (5/11), parietal (11/ 11) and temporal cortex (3/11). CONCLUSION: Crossed cerebellar diaschisis (CCD) and cortical diaschisis frequently were observed in patients with subcortical hematoma without cortical structural abnormality. This suggested that CCD can develop regardless of interruption of the corticopontocerebellar tract, which is the principal pathway of CCD.
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Byung Moon(김병문) ORCID logo https://orcid.org/0000-0001-8593-6841
Ryu, Young Hoon(유영훈) ORCID logo https://orcid.org/0000-0002-9000-5563
Lee, Jong Doo(이종두)
Lim, Joon Seok(임준석) ORCID logo https://orcid.org/0000-0002-0334-5042
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