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Isolated Hemiataxia and Cerebellar Diaschisis after a Small Dorsolateral Medullary Infarct

Masahiko Kishi1, Ryuji Sakakibara, Takeki Nagao

  • 1Neurology Division, Department of Internal Medicine, Sakura Medical Center, Toho University, Sakura, Japan.

Case Reports in Neurology
|September 18, 2010
PubMed

Insights

Isolated hemiataxia, a rare condition, can result from a small medullary infarct affecting the inferior cerebellar peduncle. This case highlights the specific neuroanatomical link between medullary lesions and cerebellar dysfunction.

Area of Science:

  • Neurology
  • Neuroimaging
  • Cerebrovascular Diseases

Background:

  • Medullary infarcts can cause diverse neurological deficits.
  • Isolated hemiataxia is an uncommon presentation following a stroke.

Observation:

  • An 83-year-old man presented with acute left-sided hemiataxia affecting the arm and bilateral legs.
  • Neurological examination revealed no other deficits, including speech or extraocular movements.

Findings:

  • Brain MRI identified a small infarct in the left dorsolateral medulla, involving the inferior cerebellar peduncle.
  • 123-iodine-123-labeled N,N,N'-triethylhexylmethylene diamine (ECD)-SPECT revealed hypoperfusion in the left cerebellar hemisphere.

Implications:

  • This case underscores the inferior cerebellar peduncle's role in mediating ipsilateral ataxia.
  • Medullary infarcts, even small ones, can lead to specific cerebellar signs.
  • Neuroimaging is crucial for localizing lesions responsible for isolated hemiataxia.

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