Cerebellitis

Case contributed by A.Prof Frank Gaillard

Presentation

9 year old with Treacher-Collins syndrome - rapid onset of head ache, torticollis and papilloedma.

Patient Data

Age: 9 years
MRI

MRI brain

This demonstrates unilateral enlargement of the left cerebellar hemisphere, in particular the neocerebellum with evidence of hypointensity of the affected segment on T1 and hyperintensity on T2. The ipsilateral folia appear marginally enlarged with distortion of the fourth ventricle and deviation of the brainstem to the right. There is associated leptomeningeal enhancement. Both lateral, third, and temporal horns are dilated. No intraparenchymal abnormalities demonstrated. 

MRI

MRI brain: 6 months later

There has been resolution of the previous abnormal T2 bright signal in the left cerebellar hemisphere. Residual T2 brightness seen peripherally does appear to be due to volume loss with increased extra-axial CSF. The deep left cerebellum, vermis and right cerebellar hemisphere show normal appearances. 

The supratentorial structures are normal. The third and lateral ventricles have reduced in size from before in keeping with improvement of a degree of hydrocephalus that was present with the initial cerebellar abnormality. 

Case Discussion

This case illustrates how important it is to take all imaging findings in the clinical context. This patient's cerebellitis has imaging appearances very similar to Lhermitte-Duclos disease. 

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Case information

rID: 16635
Case created: 5th Feb 2012
Last edited: 8th Jan 2017
Inclusion in quiz mode: Included

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