Superficial siderosis

Case contributed by Dalia Ibrahim
Diagnosis almost certain

Presentation

Remote history of head trauma and hemorrhage few years ago that had been treated surgically. Few years later he developed hydrocephalus for which he had been treated by VP shunt insertion about one year before. Now he complains of bladder incontinence, his physician suspects failure/obstruction of the VP shunt.

Patient Data

Age: 45 years
Gender: Male
mri

Low signal regions lining the surface of the superior aspect of the cerebellum and the midbrain tectal plate (more at the right side which also appears rather smaller than the left side). The low signal regions demonstrate blooming on the SWI, consistent with susceptibility artifact from hemosiderin. 

Right VP shunt.

No evidence of hydrocephalus.

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