F-18 FDG PET demonstrates crossed cerebellar diaschisis 20 years after stroke

Clinical Nuclear Medicine
Wei-Jen ShihPrimo P Milan

Abstract

Stroke produces an area of focal damage and distant areas of reduced blood blow and metabolism termed diaschisis. Tc-99m ECD and HMPAO brain SPECT have demonstrated crossed cerebellar diaschisis (CCD) in patients with cerebral cortical infarct. SPECT findings reflect abnormal cerebral blood flow. CCD as shown on F-18 FDG PET reflects abnormal reflects glucose metabolism. We present the case of a patient with laryngeal cancer who also had a stroke in the left cerebral hemisphere involving the territory of the middle cerebral artery 20 years ago. This patient underwent PET, including the head and neck. A current brain F-18 FDG PET exhibited hypometabolism in the contralateral cerebellum (CCD) as well as hypometabolism of the primary insult in the left cerebral hemisphere. These findings reflect partial impairment or diminished glucose metabolism in the primary insult to the cerebrum and contralateral cerebellum. In addition, this patient illustrates that on PET imaging, CCD could be demonstrated 20 years after a stroke.

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Citations

Aug 10, 2011·Clinical Nuclear Medicine·Valentina GaribottoOsman Ratib
Dec 17, 2011·Indian Journal of Nuclear Medicine : IJNM : the Official Journal of the Society of Nuclear Medicine, India·Madhavi TripathiAnupam Mondal
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Dec 4, 2019·Topics in Magnetic Resonance Imaging : TMRI·Timothy M Shepherd, Gopi K Nayak
Jan 11, 2019·Contrast Media & Molecular Imaging·Ana JoyaAbraham Martín
Mar 12, 2021·Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism·Karine ProvostGil D Rabinovici

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