Question 446
{"accessible":true,"alternatives":[{"id":2238,"text":"abscess"},{"id":2239,"text":"glioblastoma"},{"id":2240,"text":"haemangioblastoma"},{"id":2241,"text":"metastasis"},{"id":2242,"text":"pilocytic astrocytoma"}],"archived":false,"correctAlternativeId":2241,"explanation":"\u003cp\u003eIn an elderly patient metastasis or abscess are most likely. The presence of central enhancement strongly argues against an abscess. DWI should be reviewed for degree of central diffusion restriction (profound in abscess, usually facilitated in metastasis unless haemorrhagic).\u0026nbsp;\u003c/p\u003e\u003cp\u003eHaemangioblastoma is the most common primary cerebellar mass\u0026nbsp;but tends to present in younger individuals (e.g. 30-60 years of age).\u003c/p\u003e\u003cp\u003ePilocytic astrocytomas\u0026nbsp;are in much younger individuals (usually paediatric).\u0026nbsp;\u003c/p\u003e\u003cp\u003eGlioblastoma is very rare in the cerebellum.\u0026nbsp;\u003c/p\u003e\u003cp\u003e\u003c/p\u003e","id":446,"imageUrl":"https://prod-images-static.radiopaedia.org/multiple_choice_questions/735/image0002_big_gallery.jpeg","imageAttribution":{"kind":"case","rID":38835},"imageAttributionCaseInfo":{"title":"Cerebellar metastasis","contributor_name":"Frank Gaillard","contributor_param":"frank","case_rid":38835,"case_param":"cerebellar-metastasis-3"},"firstQuestionPath":"/questions/2330","nextQuestionPath":"/articles/brain-metastases/questions/445","relatedArticles":[{"id":1412,"title":"Haemangioblastoma (central nervous system)","link":"/articles/haemangioblastoma-central-nervous-system-2?lang=gb"},{"id":1876,"title":"Pilocytic astrocytoma","link":"/articles/pilocytic-astrocytoma?lang=gb"},{"id":6677,"title":"Cerebral abscess","link":"/articles/cerebral-abscess-1?lang=gb"},{"id":1914,"title":"Posterior cranial fossa tumours","link":"/articles/posterior-cranial-fossa-tumours?lang=gb"},{"id":4910,"title":"Glioblastoma, IDH-wildtype","link":"/articles/glioblastoma-idh-wildtype?lang=gb"},{"id":34339,"title":"Cerebral abscess (summary)","link":"/articles/cerebral-abscess-summary?lang=gb"}],"alsoUsedIn":[],"stem":"\u003cp\u003eAn 80-year-old man presents with ataxia and an MRI is performed. What is the most likely diagnosis?\u0026nbsp;\u003c/p\u003e","menuLinks":[{"text":"Report problem with question","url":"https://docs.google.com/forms/d/e/1FAIpQLSfO3soWYhOjJ7yErSysyCe5V4A1CqW7WK3rDA7MtAkecMGqNw/viewform?entry.1624461248\u0026entry.553583435=https://radiopaedia.org/questions/446"}],"attemptsPercentages":[{"alternativeId":"2241","percentage":77},{"alternativeId":"2238","percentage":7},{"alternativeId":"2240","percentage":5},{"alternativeId":"2239","percentage":8},{"alternativeId":"2242","percentage":3}],"promptToLogin":false,"questionManager":false,"articleId":"brain-metastases"}