Crossed Cerebellar Diaschisis in a Status Epilepticus Patient with Stroke-Mimicking Changes : A Case Report with Suboptimal Outcome

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dc.contributor.authorBalodis, Arturs
dc.contributor.authorRzajeva, Tatjana
dc.contributor.authorKalējs, Verners Roberts
dc.contributor.authorSmilga , Toms Mārtiņš
dc.contributor.authorPūpola, Marta
dc.contributor.institutionDepartment of Radiology
dc.date.accessioned2024-01-16T10:00:01Z
dc.date.available2024-01-16T10:00:01Z
dc.date.issued2024-01-15
dc.descriptionPublisher Copyright: © Am J Case Rep, 2024;.
dc.description.abstractBACKGROUND Crossed cerebellar diaschisis is a rare phenomenon characterized by reduction of hemispheric cerebellar blood flow and metabolism that occurs contralateral to supratentorial injury. This finding is generally detected after ischemic stroke, but can also be observed during status epilepticus. CASE REPORT A 45-year-old woman with a history of focal epilepsy and alcohol abuse presented with an episode of seizure with initial stroke-mimicking changes and no epileptiform activity on electroencephalogram. Upon further examination, the radiological findings revealed a broad cytotoxic edema in the left hemisphere and a smaller lesion in the right cerebellum, showing a rare phenomenon of crossed cerebellar diaschisis. Later, diagnosis of status epilepticus was established. Although the initial trend of the patient's condition was negative, after weeks of therapy and intensive care, the patient slightly improved in her condition and there was a partially reversible lesion in the left cerebral hemisphere and right cerebellum. CONCLUSIONS It is crucial to detect seizures in patients with stroke-like changes on unenhanced computed tomography examination, and especially in cases in which there are no arterial occlusion on computed tomography angiography and asymmetric arterial vasodilatation are seen. Status epilepticus can mimic stroke, establishing this as a major diagnostic challenge. Although the radiological findings in the left cerebral hemisphere lesion and the right cerebellar hemisphere were similar, its characteristics on diffusion-weighted imaging and apparent diffusion coefficient value differed, raising an important question of the exact mechanics of how crossed cerebellar diaschisis occurs, as it seems to be a rare phenomenon.en
dc.description.statusPeer reviewed
dc.format.extent2230800
dc.identifier.citationBalodis, A, Rzajeva, T, Kalējs, V R, Smilga , T M & Pūpola, M 2024, 'Crossed Cerebellar Diaschisis in a Status Epilepticus Patient with Stroke-Mimicking Changes : A Case Report with Suboptimal Outcome', American Journal of Case Reports, vol. 25, e942715. https://doi.org/10.12659/AJCR.942715
dc.identifier.doi10.12659/AJCR.942715
dc.identifier.issn1941-5923
dc.identifier.urihttps://dspace.rsu.lv/jspui/handle/123456789/15108
dc.identifier.urlhttp://www.scopus.com/inward/record.url?scp=85182542119&partnerID=8YFLogxK
dc.language.isoeng
dc.relation.ispartofAmerican Journal of Case Reports
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectBrain edema
dc.subjectCerebellum
dc.subjectDiaschisis
dc.subjectEpilepsy
dc.subjectTonic-Clonic
dc.subjectSeizure
dc.subject3.2 Clinical medicine
dc.subject1.1. Scientific article indexed in Web of Science and/or Scopus database
dc.titleCrossed Cerebellar Diaschisis in a Status Epilepticus Patient with Stroke-Mimicking Changes : A Case Report with Suboptimal Outcomeen
dc.type/dk/atira/pure/researchoutput/researchoutputtypes/contributiontojournal/article

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