Crossed cerebellar diaschisis

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Crossed cerebellar diaschisis (CCD) refers to a depression of blood flow and metabolism affecting the cerebellar hemisphere occurring as a result of a contralateral focal, supratentorial lesion (e.g. infarct, radiation necrosis, following tumour resection).

Pathology

It is a well-recognised phenomenon following cerebral infarction. The most likely mechanism is thought to be interruption of cortico-ponto-cerebellar connections due to the infarct which then causes deafferentation and transneural metabolic depression of the contralateral cerebellar hemisphere

Radiographic features

Imaging has to be interpreted in the correct clinical context.

CT / MRI and CT perfusion

CT perfusion performed during acute stroke may show a contralateral perfusion abnormality in about 20 % of cases ⁴. CBF and CBV maps show only mild-to-moderate reduction in these parameters, and are never low enough to classify the personal abnormalities as infarcts. There can be volume loss to the contralateral cerebellar hemisphere.

Nuclear medicine

FDG PET shows hypometabolism in affected cerebellar hemisphere ².

-<p><strong>Crossed cerebellar diaschisis (CCD)</strong> refers to a depression of blood flow and metabolism affecting the <a title="Cerebellum" href="/articles/cerebellum">cerebellar hemisphere</a> occurring as a result of a contralateral focal, supratentorial lesion (e.g. <a title="Ischaemic stroke" href="/articles/ischaemic-stroke">infarct</a>, <a title="Cerebral radiation necrosis" href="/articles/cerebral-radiation-necrosis-1">radiation necrosis</a>, following tumour resection).</p><h4>Pathology</h4><p>It is a well-recognised phenomenon following cerebral infarction. The most likely mechanism is thought to be interruption of cortico-ponto-cerebellar connections due to the infarct which then causes deafferentation and transneural metabolic depression of the contralateral cerebellar hemisphere</p><h4>Radiographic features</h4><p>Imaging has to be interpreted in the correct clinical context. </p><h5>CT / MRI and CT perfusion</h5><p>CT perfusion performed during acute stroke may show a contralateral perfusion abnormality in about 20 % of cases <sup>4</sup>. <a title="Cerebral blood flow (CBF)" href="/articles/cerebral-blood-flow-cbf">CBF</a> and <a title="Cerebral blood volume (CBV)" href="/articles/cerebral-blood-volume-cbv">CBV</a> maps show only mild-to-moderate reduction in these parameters, and are never low enough to classify the personal abnormalities as infarcts. There can be volume loss to the contralateral cerebellar hemisphere.</p><h5>Nuclear medicine</h5><p>FDG PET shows hypometabolism in affected cerebellar hemisphere <sup>2</sup>.</p>
+<p><strong>Crossed cerebellar diaschisis (CCD)</strong> refers to a depression of blood flow and metabolism affecting the <a href="/articles/cerebellum">cerebellar hemisphere</a> occurring as a result of a contralateral focal, supratentorial lesion (e.g. <a href="/articles/ischaemic-stroke">infarct</a>, <a href="/articles/cerebral-radiation-necrosis-1">radiation necrosis</a>, following tumour resection).</p><h4>Pathology</h4><p>It is a well-recognised phenomenon following cerebral infarction. The most likely mechanism is thought to be interruption of cortico-ponto-cerebellar connections due to the infarct which then causes deafferentation and transneural metabolic depression of the contralateral cerebellar hemisphere</p><h4>Radiographic features</h4><p>Imaging has to be interpreted in the correct clinical context. </p><h5>CT / MRI and CT perfusion</h5><p>CT perfusion performed during acute stroke may show a contralateral perfusion abnormality in about 20 % of cases <sup>4</sup>. <a href="/articles/cerebral-blood-flow-cbf">CBF</a> and <a href="/articles/cerebral-blood-volume-cbv">CBV</a> maps show only mild-to-moderate reduction in these parameters, and are never low enough to classify the personal abnormalities as infarcts. There can be volume loss to the contralateral cerebellar hemisphere.</p><h5>Nuclear medicine</h5><p>FDG PET shows hypometabolism in affected cerebellar hemisphere <sup>2</sup>.</p>

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