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Crossed Cerebellar Diaschisis
Santhosh Gaddikeri, MD; Miral D. Jhaveri, MD, MBA
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          TERMINOLOGY

          • Abbreviations

            • Crossed cerebellar diaschisis (CCD)
          • Definitions

            • Diaschisis: Sudden loss of function in brain connected to (but at distance from) damaged area
            • CCD: Decreased blood flow/metabolism in cerebellar hemisphere contralateral to supratentorial infarct
              • Caused by interrupted afferent input through corticopontocerebellar tract (CPC)
            • CCD occurs in both acute & chronic phases
              • Acute CCD results from functional deafferentation
              • Subacute, chronic CCD reflects transneuronal degeneration

          IMAGING

          • General Features

            • Imaging Recommendations

              • CT Findings

                • MR Findings

                  • Nuclear Medicine Findings

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        CLINICAL ISSUES

                        • Natural History & Prognosis

                          Selected References

                          1. Zhang M et al: Characteristics of cerebral perfusion and diffusion associated with crossed cerebellar diaschisis after acute ischemic stroke. Jpn J Radiol. 38(2):126-34, 2020
                          2. Kim JS et al: Degeneration of the inferior cerebellar peduncle after middle cerebral artery stroke: another perspective on crossed cerebellar diaschisis. Stroke. 50(10):2700-7, 2019
                          3. Yokota H et al: Crossed cerebellar diaschisis in status epilepticus. Neurochirurgie. 65(6):425-6, 2019
                          4. Liu X et al: Pathological factors contributing to crossed cerebellar diaschisis in cerebral gliomas: a study combining perfusion, diffusion, and structural MR imaging. Neuroradiology. 60(6):643-50, 2018
                          5. Reesink FE et al: Crossed cerebellar diaschisis in Alzheimer's disease. Curr Alzheimer Res. 15(13):1267-75, 2018
                          6. Strother MK et al: Crossed cerebellar diaschisis after stroke identified noninvasively with cerebral blood flow-weighted arterial spin labeling MRI. Eur J Radiol. 85(1):136-42, 2016
                          7. Chen S et al: Crossed cerebellar diaschisis detected by arterial spin-labeled perfusion magnetic resonance imaging in subacute ischemic stroke. J Stroke Cerebrovasc Dis. 23(9):2378-83, 2014
                          8. Zaidi SA et al: Crossed cerebellar diaschisis: a radiological finding in status epilepticus not to miss. BMJ Case Rep. 2013, 2013
                          9. Jeon YW et al: Dynamic CT perfusion imaging for the detection of crossed cerebellar diaschisis in acute ischemic stroke. Korean J Radiol. 13(1):12-9, 2012
                          10. Massaro AM: Teaching neuroimages: crossed cerebellar diaschisis in hemispheric status epilepticus. Neurology. 79(20):e182, 2012
                          11. Agrawal KL et al: Crossed cerebellar diaschisis on F-18 FDG PET/CT. Indian J Nucl Med. 26(2):102-3, 2011
                          12. Garg G et al: Crossed cerebellar diaschisis demonstrated by (18)F- FDG-PET/CT. Hell J Nucl Med. 12(2):171-2, 2009
                          13. Huang YC et al: Periictal magnetic resonance imaging in status epilepticus. Epilepsy Res. 86(1):72-81, 2009
                          14. Lin DD et al: Crossed cerebellar diaschisis in acute stroke detected by dynamic susceptibility contrast MR perfusion imaging. AJNR Am J Neuroradiol. 30(4):710-5, 2009
                          15. Dodick DW et al: Crossed cerebellar diaschisis during migraine with prolonged aura: a possible mechanism for cerebellar infarctions. Cephalalgia. 28(1):83-6, 2008
                          16. Kajimoto K et al: Crossed cerebellar diaschisis: a positron emission tomography study with L-[methyl-11C]methionine and 2-deoxy-2-[18F]fluoro-D-glucose. Ann Nucl Med. 21(2):109-13, 2007
                          17. Liu Y et al: Crossed cerebellar diaschisis in acute ischemic stroke: a study with serial SPECT and MRI. J Cereb Blood Flow Metab. 27(10):1724-32, 2007
                          18. Kim J et al: Decreased fractional anisotropy of middle cerebellar peduncle in crossed cerebellar diaschisis: diffusion-tensor imaging-positron-emission tomography correlation study. AJNR Am J Neuroradiol. 26(9):2224-8, 2005
                          Related Anatomy
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                          Related Differential Diagnoses
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                          References
                          Tables

                          Tables

                          KEY FACTS

                          • Terminology

                            • Imaging

                              • Top Differential Diagnoses

                                • Pathology

                                  TERMINOLOGY

                                  • Abbreviations

                                    • Crossed cerebellar diaschisis (CCD)
                                  • Definitions

                                    • Diaschisis: Sudden loss of function in brain connected to (but at distance from) damaged area
                                    • CCD: Decreased blood flow/metabolism in cerebellar hemisphere contralateral to supratentorial infarct
                                      • Caused by interrupted afferent input through corticopontocerebellar tract (CPC)
                                    • CCD occurs in both acute & chronic phases
                                      • Acute CCD results from functional deafferentation
                                      • Subacute, chronic CCD reflects transneuronal degeneration

                                  IMAGING

                                  • General Features

                                    • Imaging Recommendations

                                      • CT Findings

                                        • MR Findings

                                          • Nuclear Medicine Findings

                                            DIFFERENTIAL DIAGNOSIS

                                              PATHOLOGY

                                              • General Features

                                                CLINICAL ISSUES

                                                • Natural History & Prognosis

                                                  Selected References

                                                  1. Zhang M et al: Characteristics of cerebral perfusion and diffusion associated with crossed cerebellar diaschisis after acute ischemic stroke. Jpn J Radiol. 38(2):126-34, 2020
                                                  2. Kim JS et al: Degeneration of the inferior cerebellar peduncle after middle cerebral artery stroke: another perspective on crossed cerebellar diaschisis. Stroke. 50(10):2700-7, 2019
                                                  3. Yokota H et al: Crossed cerebellar diaschisis in status epilepticus. Neurochirurgie. 65(6):425-6, 2019
                                                  4. Liu X et al: Pathological factors contributing to crossed cerebellar diaschisis in cerebral gliomas: a study combining perfusion, diffusion, and structural MR imaging. Neuroradiology. 60(6):643-50, 2018
                                                  5. Reesink FE et al: Crossed cerebellar diaschisis in Alzheimer's disease. Curr Alzheimer Res. 15(13):1267-75, 2018
                                                  6. Strother MK et al: Crossed cerebellar diaschisis after stroke identified noninvasively with cerebral blood flow-weighted arterial spin labeling MRI. Eur J Radiol. 85(1):136-42, 2016
                                                  7. Chen S et al: Crossed cerebellar diaschisis detected by arterial spin-labeled perfusion magnetic resonance imaging in subacute ischemic stroke. J Stroke Cerebrovasc Dis. 23(9):2378-83, 2014
                                                  8. Zaidi SA et al: Crossed cerebellar diaschisis: a radiological finding in status epilepticus not to miss. BMJ Case Rep. 2013, 2013
                                                  9. Jeon YW et al: Dynamic CT perfusion imaging for the detection of crossed cerebellar diaschisis in acute ischemic stroke. Korean J Radiol. 13(1):12-9, 2012
                                                  10. Massaro AM: Teaching neuroimages: crossed cerebellar diaschisis in hemispheric status epilepticus. Neurology. 79(20):e182, 2012
                                                  11. Agrawal KL et al: Crossed cerebellar diaschisis on F-18 FDG PET/CT. Indian J Nucl Med. 26(2):102-3, 2011
                                                  12. Garg G et al: Crossed cerebellar diaschisis demonstrated by (18)F- FDG-PET/CT. Hell J Nucl Med. 12(2):171-2, 2009
                                                  13. Huang YC et al: Periictal magnetic resonance imaging in status epilepticus. Epilepsy Res. 86(1):72-81, 2009
                                                  14. Lin DD et al: Crossed cerebellar diaschisis in acute stroke detected by dynamic susceptibility contrast MR perfusion imaging. AJNR Am J Neuroradiol. 30(4):710-5, 2009
                                                  15. Dodick DW et al: Crossed cerebellar diaschisis during migraine with prolonged aura: a possible mechanism for cerebellar infarctions. Cephalalgia. 28(1):83-6, 2008
                                                  16. Kajimoto K et al: Crossed cerebellar diaschisis: a positron emission tomography study with L-[methyl-11C]methionine and 2-deoxy-2-[18F]fluoro-D-glucose. Ann Nucl Med. 21(2):109-13, 2007
                                                  17. Liu Y et al: Crossed cerebellar diaschisis in acute ischemic stroke: a study with serial SPECT and MRI. J Cereb Blood Flow Metab. 27(10):1724-32, 2007
                                                  18. Kim J et al: Decreased fractional anisotropy of middle cerebellar peduncle in crossed cerebellar diaschisis: diffusion-tensor imaging-positron-emission tomography correlation study. AJNR Am J Neuroradiol. 26(9):2224-8, 2005