Occurrence of Subtle Scoliosis in Accordance with Development of Ipsilateral Cerebellar Diaschisis on Brain SPECT in a Patient with Head Injury

Received 10/6/2004; revised 12/2/2004; accepted 12/9/2004. For correspondence or reprints contact: Shin-Tsu Chang, M.D., Departments of Physical Medicine and Rehabilitation, Tri-Service General Hospital, 325 Section 2, Cheng-Kong Road, Taipei 114, Taiwan, ROC. Tel: (886)2-87923311 ext. 13325, Fax: (886)2-26321954, E-mail: [email protected] A 23-year-old male patient with a head injury 20 months ago visited our OPD on account of shortening height from 167 cm to 165 cm within a 2-month period. Scoliosis series of the whole spine X-rays revealed a slight convex in the left side with a 4-degree curve of scoliosis measured by the Cobb’s method. Brain SPECT with Tc-HMPAO images showed a reduction of perfusion to the left cerebellar hemisphere, e.g. ipsilateral cerebellar diaschisis (ICD), because the left cerebral cortex had severely wronged including the left frontal, temporal and parietal-occipital regions. We speculated that the occurrence of scoliosis together with impaired cerebellar perfusion following head injury might be associated with damage to the efferent fibers from the cerebellum and the ICD observed in the chronic stage of brain damage probably was caused by a late involvement of the cortico-pontocerebellar tract at the level of the frontal cortex.