Cerebellar diaschisis and contralateral thalamus hyperperfusion in a stroke patient with complex regional pain syndrome

J Clin Neurosci. 2008 Oct;15(10):1166-8. doi: 10.1016/j.jocn.2007.06.017. Epub 2008 Aug 15.

Abstract

We present a right-hemispheric stroke patient with complex regional pain syndrome (CRPS). The regional cerebral blow flow (rCBF) as determined using single photon emission computed tomography (SPECT) showed contralateral increase of tracer uptake in the left thalamus accompanied by crossed cerebellar diaschisis (CCD) in the left cerebellum. After rehabilitation, the CRPS in the right upper extremity recovered, although hemiplegia persisted on the left limbs. The rCBF determined a second time using SPECT showed that uptake was normal in the bilateral thalami, basal ganglia and bilateral cerebella. At a 6-month follow-up, the CRPS had not recurred. Our findings show that analysis of rCBF by SPECT is useful for the clinical evaluation and follow-up of CRPS. To the best of our knowledge, this is the first reported case with this particular pattern of symptoms amd symptom resolution.

Publication types

  • Case Reports

MeSH terms

  • Cerebellar Diseases / diagnostic imaging
  • Cerebellar Diseases / etiology*
  • Cerebellar Diseases / physiopathology
  • Cerebrovascular Circulation*
  • Complex Regional Pain Syndromes / etiology*
  • Complex Regional Pain Syndromes / physiopathology
  • Functional Laterality
  • Humans
  • Male
  • Middle Aged
  • Neural Pathways / blood supply
  • Neural Pathways / physiopathology
  • Regional Blood Flow
  • Stroke / complications*
  • Stroke / diagnostic imaging
  • Stroke / physiopathology
  • Thalamus / blood supply*
  • Thalamus / diagnostic imaging
  • Thalamus / physiopathology
  • Tomography, Emission-Computed, Single-Photon