Published Online
on November 23, 2005

A more recent version of this article appeared on January 1, 2006

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Submitted on June 24, 2005
Accepted on July 18, 2005

Ataxic Hemiparesis From Strategic Frontal White Matter Infarction With Crossed Cerebellar Diaschisis

Alexander C. Flint MD, PhD; MaryAlice C. Naley MD; and Clinton B. Wright MD^*

From the Neurological Institute of New York, Columbia University Medical Center, New York.

^* To whom correspondence should be addressed. E-mail: cwright{at}neuro.columbia.edu.

Background--Ataxic hemiparesis is a classic lacunar syndrome that most often localizes to the pons.

Results--We report 3 patients who presented with left-sided ataxic hemiparesis and were found on imaging to have small right frontal subcortical white matter infarcts in similar locations by diffusion-weighted MRI. [^99mTc]hexamethylpropylenamine oxime single-photon emission computed tomography (SPECT) scans in all 3 patients showed decreased metabolism in the contralateral cerebellar hemisphere, indicative of crossed cerebellar diaschisis (CCD).

Conclusion--CCD is under-recognized in ataxic hemiparesis and may have implications for functional recovery after this type of ischemic stroke.

Key words: ataxia • lacunar infarction • magnetic resonance imaging • tomography, emission computed • stroke

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