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Case Reports
. 2017 Jan;96(2):e5646.
doi: 10.1097/MD.0000000000005646.

Case report: Rapid improvement of crossed cerebellar diaschisis after intravascular laser irradiation of blood in a case of stroke

Wan-Hua Yang  1 , Shiou-Ping Lin, Shin-Tsu Chang
Affiliations
Case Reports

Case report: Rapid improvement of crossed cerebellar diaschisis after intravascular laser irradiation of blood in a case of stroke

Wan-Hua Yang et al. Medicine (Baltimore). 2017 Jan.

Abstract

Rationale: Crossed cerebellar diaschisis (CCD) is a poor prognostic factor after stroke because without immediate cerebral reperfusion no further improvements in the patient's condition can be achieved. We investigated the clinical effects of intravascular laser irradiation therapy (ILIB) on CCD and evaluated the therapeutic effect in the sub-acute post-stroke stage.

Patient concerns: The 77-year-old male with cerebral infarction in the territory of the right anterior cerebral artery only underwent conservative treatment including hydration and aspirin in the acute post-stroke stage.

Diagnosis: He was diagnosed as stroke based on the clinical presentations and imaging findings.

Intervention: Once the patient was in stable condition, he underwent a daily hour-long ILIB (He-Ne laser) for ten consecutive days during the sub-acute post-stroke stage.

Outcomes: We used single-photon emission computed tomography (SPECT) before and after intravascular laser irradiation to detect changes in cerebral and cerebellar perfusion. Then, we compared the two images. CCD was detected using the first SPECT. After intervention by ILIB, the second SPECT showed greater perfusion in the affected cerebellar hemisphere.

Lessons: We found that ILIB helped eliminate CCD, which was previously shown to be an untreatable condition using any intervention during the sub-acute post-stroke stage. Stroke patients could therefore greatly benefit from ILIB.

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Conflict of interest statement

The authors have no funding and conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Brain MRI. (A and B) Serial FLAIR MRI shows the high signal intensity in the territory of the right anterior cerebral artery, which indicates recent cerebral infarction. MRI = magnetic resonance imaging.
Figure 2
Figure 2
Regional perfusion SPECT before and after intravascular laser irradiation. The 2 SPECT images show the regional perfusion. The white to red area indicated better perfusion than the blue and green area. (A) This regional perfusion SPECT (conducted on poststroke day 14) shows that the infarction region (indicated by red arrow) covers the territory of the anterior cerebral artery on the right hemisphere and decreased perfusion on the left cerebellar hemisphere (indicated by red arrow head). (B) The second regional perfusion SPECT (conducted on poststroke day 63) still showed hypoperfusion in the right cerebral hemisphere (indicated by white arrow), but more blood flow in the left cerebellar hemisphere (indicated by white arrow head). SPECT = single-photon emission computed tomography.
Figure 3
Figure 3
Timeline. The timeline containing the interventions, image reports, and general conditions provided the time course of this patient we presented.
See this image and copyright information in PMC

References

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