Cerebellar diaschisis and contralateral thalamus hyperperfusion in a stroke patient with complex regional pain syndrome.
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.
Lai
Min-Hsin
MH
Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, No. 325, Section 2, Cheng-Kung Road, Neihu District, Taipei 114, Taipei, Taiwan.
Wang
Tzu-Yun
TY
Chang
Cheng-Chiang
CC
Li
Tsung-Ying
TY
Chang
Shin-Tsu
ST
D002526:Cerebellar Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D002560:Cerebrovascular Circulation; D020918:Complex Regional Pain Syndromes / Q000209:etiology* / Q000503:physiopathology; D007839:Functional Laterality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009434:Neural Pathways / Q000098:blood supply / Q000503:physiopathology; D012039:Regional Blood Flow; D020521:Stroke / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D013788:Thalamus / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000503:physiopathology; D015899:Tomography, Emission-Computed, Single-Photon