Bilateral cerebellar space-occupying lesions eliciting low signal on T2 and FLAIR WI. They appear as coalescent ring-enhancing nodules merging into large lesions. The lesions are surrounded by vasogenic edema signal and exert positive mass effect in the form of compression of the 4th ventricle and subsequent moderate supratentorial hydrocephalus, as well as mild cerebellar tonsillar herniation.
MRS showed a markedly elevated lipid/lactate peak. No significant elevation of the Choline peak.
Radiological findings with the characteristic low T2 signal and coalescent ring-enhancing nodules are suggestive of cerebellar tuberculomas.