Cerebellar Cognitive Affective Syndrome in the Context of Crossed Cerebellar Diaschisis Post Pontine Infarction
Alpha Oumar Diallo1,2*, Marie-Dominique Gazagnes1, Gauthier Namur3, Anissa Ourtani1,4,5
1Department of Neurology, Centre Hospitalier Universitaire Brugmann, Brussels, Belgium.
2Neurovascular Health Program, Centre Hospitalier de l’Universite de Montreal (CHUM), Montreal, QC, Canada.
3Department of Radiology, Clinique CHC MontLe gia, Lie ge, Belgium.
4Department of Neurology, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium.
5Neuroprotection & Neuromodulation (NEUR) Research Group, Center for Neurosciences (C4N), Vrije Universiteit Brussel (VUB), Brussels, Belgium.
*Corresponding Author: Alpha Oumar Diallo, Centre Hospitalier de l’Universite de Montreal (CHUM)1000, rue Saint-Denis, Montreal, QC H2X 0C1
https://doi.org/10.58624/SVOANE.2025.06.021
Received: June 25, 2025
Published: July 29, 2025
Citation: Diallo AO, Gazagnes MD, Namur G, Ourtani A. Cerebellar Cognitive Affective Syndrome in the Context of Crossed Cerebellar Diaschisis Post Pontine Infarction. SVOA Neurology 2025, 6:4, 108-111. doi. 10.58624/SVOANE.2025.06.021
Abstract
Crossed cerebellar diaschisis (CCD) is characterized by reduced blood flow and hypometabolism in the cerebellum secondary to a supratentorial lesion in the contralateral cerebral hemisphere. Although CCD due to an infratentorial lesion, particularly a pontine infarction, is rare, it has been previously described. We report a case of a middle-aged man with left paramedian pontine infarction who developed new-onset cognitive dysfunction. Neuropsychological assessment revealed deficits consistent with cerebellar cognitive affective syndrome (CCAS). Brain single-photon emission computed tomography showed hypometabolism in the posterior right cerebellar hemisphere, consistent with CCD. We hypothesize that the cognitive dysfunction, compatible with CCAS following the left pontine infarction, can be explained by CCD-related hypometabolism in the right cerebellum. This case contributes to the limited literature on CCD from infratentorial lesions, emphasizing the potential for CCAS to arise from pontine infarction.
Keywords: Crossed cerebellar diaschisis; Cerebellar cognitive affective syndrome; Pontine infarction.
