Presentation
Headache, dizziness and vertigo
Patient Data
There is a geographic hypointense T1 and hyperintense T2/FLAIR lesion in the superomedial aspect of the right cerebellar hemisphere with partial involvement of the superior vermis. It showed diffusion restriction on DWI/ADC map.
No involvement of the midbrain. No intracerebral haemorrhage or extra-axial haematoma. No masses. No hydrocephalus.
Case Discussion
Appearances, in this case, are compatible with an acute right distal superior cerebellar artery infarction. It accounts for about 50% of cerebellar infarcts. Two patterns are described according to the site of occlusion:
- occlusion at the origin of the artery results in cerebellar and brain stem signs with contralateral sensory impairment
- peripheral occlusion results in ipsilateral cerebellar signs as in this case
Causes include atherosclerosis, emboli and dissection of vertebral or basilar arteries. This case is likely due to embolic cause.
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