Revision 13 for 'Crossed cerebellar diaschisis'

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Crossed cerebellar diaschisis

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, supra-tentorial lesion (e.g. infarct, radiation necrosis, following a tumor resection).

Pathology

It is a well-recognized 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

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 the parameters and are never low to classify them as infarcts. There can be volume loss to the contra lateral cerebellar hemisphere.

FDG-PET

Shows hypo metabolism in affected cerebellar hemisphere 2.

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