Cerebellar stroke

Case contributed by Dr Jeremy Jones

Presentation

Headache. Unwell for several days with vomiting. Off legs for the last 24 hours. No trauma. Concern for intracranial mass lesion.

Patient Data

Age: 5
Gender: Male
Modality: CT

Prospectively, with the history given, this CT was called normal. Retrospectively, the area of hypodensity in the right cerebellar hemisphere is evident.

Modality: MRI

Abnormality centered on the superior surface of the right cerebellar hemisphere in the region of the right superior peduncle extending to the brainstem. T2 hyper intense, T1 hypointense, diffusion restriction and no enhancement. Features here are of ischaemia/infarction.

Case Discussion

Paediatric stroke is not uncommon and needs to be considered to get the imaging correct. The initial CT would be very easy to call normal, especially if the clinical history didn't suggest a posterior circulation vascular abnormality.

MRI is far more sensitive and allows accurate depiction of the area of infarction as well as assessment of the vascular supply.

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Case Information

rID: 32202
Case created: 18th Nov 2014
Last edited: 19th Feb 2017
Inclusion in quiz mode: Included

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