Headache, ataxia and blurred vision
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Striated appearance of the cerebellum with hyperintense signal in T2 and FLAIR and associated mild hydrocephalic changes and mild tonsillar herniation. DWI reveals increased signal which is the same in ADC map (not present here) denoting T2 shine through effect.
Diagnosis: Dysplastic cerebellar gangliocytoma (Lhermitte-Duclos disease) by MRI features.
DD of this case includes:
- cerebellar infarction: excluded by DWI
- acute cerebellitis:excluded by clinical picture
- rhombencephalosynapsis: excluded as cerebellar vermis is present
The patient was referred for upper and lower GI endoscopy searching for polyps as this condition is associated with Cowden syndrome.
- Shinagare AB, Patil NK, Sorte SZ. Case 144: Dysplastic cerebellar gangliocytoma (Lhermitte-Duclos disease). Radiology. 2009;251 (1): 298-303. Radiology (full text) - doi:10.1148/radiol.2511071390 - Pubmed citation
- Osborn A, Blaser S, Salzman K. Encyclopedia of Diagnostic Imaging. AMIRSYS. (2008) ISBN:0721629059. Read it at Google Books - Find it at Amazon