Presentation
High fever, headache, nausea, vomiting, ataxia and irritability. No past history of neurological disorder, drug usage, toxin exposure, or immunization.
Patient Data
FLAIR/ T2 demonstrate hyperintense lesions in the cortical-subcortical cerebellar hemispheres. T1 shows hypointense cerebellar hemispheres. No leptomeningeal enhancement of the cerebellum on T1 post gadolinium. No restriction of diffusion.
Case Discussion
Acute cerebellitis represents an inflammatory process involving the cerebellum as a complication that may follow systemic infection. A common neuroimaging finding is bilateral cerebellar hyperintense T2 signal.
Differential considerations for this appearance include cerebellar infarction, opioid toxicity, and PRES. Infarction and opioid toxicity would exhibit diffusion restriction, while PRES should have a history of hypertension.