Ataxic hemiparesis from strategic frontal white matter infarction with crossed cerebellar diaschisis.

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).

CONCLUSIONS

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