DOI: https://doi.org/10.22141/2224-0713.8.102.2018.153537

Case analysis of crossed pontine-cerebellar diaschisis in acute stroke patients

S.M. Vinychuk, O.Ye. Fartushna

Abstract


Background. Stroke is the second leading global cause of death behind the heart diseases, accounting for 11.8 % of total deaths worldwide. The Monakow concept of diaschisis describes neurophysiological changes that occur distant to focal brain lesion. Diaschisis plays a significant role in the severity of acute neurological deficit and spontaneous stroke recovery. However, currently there are not enough published prospective hospital-based cohort studies that report and analyze clinical characteristics of crossed pontine-cerebellar diaschisis in acute stroke patients. The purpose of this study is to determine the features of the clinical manifestations of crossed pontine-cerebellar diaschisis after acute cerebral stroke. Materials and methods. We prospectively recruited 124 acute stroke patients, who were admitted to a single department at an academic tertiary care hospital in Kyiv, Ukraine. The primary outcome was the combined incidence of stroke and diaschisis. In the secondary analyses, we evaluated pathophysiological, anatomical, and clinical features, specific to crossed pontine-cerebellar diaschisis in a cohort of acute stroke patients. Results. Among 124 selected acute stroke patients admitted to the department, 42 (33.9 %) persons were diagnosed with different forms of diaschisis. Crossed pontine-cerebellar diaschisis was detected in 5 patients. We described clinical manifestations and analyzed pathophysiological features of crossed pontine-cerebellar diaschisis in acute stroke patients. Conclusions. The main mechanism of crossed pontine-cerebellar diaschisis is an interruption of ponto-cerebellar pathway from proper nuclei of cerebellum, caused by lesion in the pons.

Keywords


crossed pontine-cerebellar diaschisis; cerebellar stroke; cerebellum; remote diaschisis; forms of diaschisis; clinical manifestations; diagnosis; case report

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References


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