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Case Reports in Medicine
Volume 2013 (2013), Article ID 519808, 4 pages
http://dx.doi.org/10.1155/2013/519808
Case Report

Concurrence of Crossed Cerebellar Diaschisis and Parakinesia Brachialis Oscitans in a Patient with Hemorrhagic Stroke

1Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, No. 325, Sec. 2, Cheng-Kung Road, Neihu District, Taipei 114, Taiwan
2Department of Rehabilitation, Taichung Veterans General Hospital, Taichung 407, Taiwan

Received 15 July 2013; Accepted 1 October 2013

Academic Editor: Aaron S. Dumont

Copyright © 2013 Yung-Tsan Wu et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Crossed cerebellar diaschisis (CCD) is defined as a reduction in blood flow in the cerebellar hemisphere contralateral to the supratentorial focal lesion. The phenomenon termed parakinesia brachialis oscitans (PBO) in which stroke patients experience involuntary stretching of the hemiplegic arm during yawning is rarely reported. The concurrence of CCD and PBO has never been described. A 52-year-old man had putaminal hemorrhage and demonstrated no significant recovery in his left hemiplegia after intensive rehabilitation, but his gait improved gradually. Two months after the stroke, the single photon emission computed tomography (SPECT) showed CCD. Four months after the stroke, the patient noticed PBO. The follow-up SPECT showed persistent CCD and the patient’s arm was still plegic. The frequency and intensity of PBO have increased with time since the stroke. We speculate that the two phenomena CCD and PBO might share similar neuroanatomical pathways and be valuable for predicting clinical recovery after stroke.