Headaches, fever, and cerebellar ataxia with an abnormal EEG.
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The MRI sequences demonstrate areas of cortical hyperintensity on FLAIR, and T2WI involving the cerebellar hemispheres, and vermis with restricted diffusion on DWI/ADC (due to cytotoxic edema). The postcontrast sequences show a leptomeningeal enhancement along the surface of the cerebellar hemispheres well-visualized on both postcontrast T1, and FLAIR.
The clinical presentation and MRI features are most consistent with an acute cerebellitis.
Additional contributor: R. Bouguelaa, MD