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The left cerebellar hemisphere is diffusely enlarged by virtue of large ill defined heterogenous lesion, showing slightly striated cystic appearance, it elicits isointense/low signal at T1 WI and being of high signal at T2 and FLAIR WI showing areas of diffusion restriction ; it shows minimal faint post contrast enhancement, the lesion extends to the cerebellar vermis.
The lesion exerts mass effect in the form mild compression of the fourth ventricle and mild cerebellar tonsillar herniation through the foramen magnum which is mildly compressing the medulla.
Subsequent supratentorial ventricular system dilatation with periventricular CSF permeation.