Cerebellar infarct and cerebellopontine angle lipoma
Known long-standing hypertension presented with acute vertigo and vomiting since few days.
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MR demonstrates an acute infarct involving the caudal portion of the right cerebellar hemisphere, an area of involvement corresponds to PICA territory.
There is a well-demarcated oval lesion in the right cerebellopontine angle which was hyperintense on T1, T2, and FLAIR with suppression on the T1Fs sequence. There is no DW restriction and extension into right IAC was noted. No parenchymal invasion. Findings most consistent with a lipoma.
There is also confluent bilateral periventricular white matter T2 hyperintense lesions due to chronic hypertensive encephalopathy.
Intracranial lipomas are rare lesions and in most of the cases they are asymptomatic and detected incidentally.