Document Detail

Crossed cerebellar atrophy in patients with precocious destructive brain insults.
MedLine Citation:
PMID:  12020269     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To analyze the frequency and pathogenetic factors of crossed cerebellar atrophy (CCA) in adult patients with epilepsy secondary to destructive brain insults of early development. METHODS: We studied 51 adult patients with epilepsy and precocious destructive lesions. Patients were divided into 3 groups according to the topographic distribution of their lesions on magnetic resonance imaging: group A, hemispheric (n = 9); group B, main arterial territory (n = 25); and group C, arterial border zone (n = 17). We evaluated the presence of CCA visually and with cerebellar volumetric measurement, correlating it with the clinical data. Other features shown on magnetic resonance imaging, such as the thalamus, brainstem, and middle cerebellar peduncle, were also carefully analyzed. RESULTS: Seven patients (13%) had CCA that was associated with the extent of the supratentorial lesion (6 from group A, 1 from group B, and none from group C; P<.001). Status epilepticus was present in 6 patients from group A and in none from the other groups. There was an association between the antecedent of status epilepticus and CCA (P<.001). All patients had atrophy of the cerebral peduncle ipsilateral to the supratentorial lesion and 4 had contralateral atrophy of the middle cerebellar peduncle. The duration of epilepsy was not associated with the presence of CCA (P =.20). CONCLUSIONS: Our data suggest that in patients with epilepsy and destructive insults early in life, the extent of the supratentorial lesion as well as the antecedent of status epilepticus play a major role in the pathogenesis of CCA. Recurrent seizures do not seem to be relevant to the development of CCA.
Ricardo A Teixeira; Li M Li; Sergio L M Santos; Veronica A Zanardi; Carlos A M Guerreiro; Fernando Cendes
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Archives of neurology     Volume:  59     ISSN:  0003-9942     ISO Abbreviation:  Arch. Neurol.     Publication Date:  2002 May 
Date Detail:
Created Date:  2002-05-21     Completed Date:  2002-06-07     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0372436     Medline TA:  Arch Neurol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  843-7     Citation Subset:  AIM; IM    
Department of Neurology, FCM-UNICAMP, Campinas, CEP 13083-970, SP, Brazil.
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MeSH Terms
Brain Infarction / complications,  pathology
Cerebellar Diseases / etiology*,  pathology*
Cerebellum / pathology
Functional Laterality
Magnetic Resonance Imaging
Middle Aged
Status Epilepticus / complications*,  pathology*

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