What is the differential diagnosis for cerebral and cerebellar microhaemorrhages?
Hypertensive microangiopathy, multiple cavernoma syndrome, haemorrhagic metastases, neurocysticercosis, diffuse axonal injury, disseminated intravascular coagulopathy, and radiation-induced vasculopathy.
Axial T2 and FLAIR show 1.4 cm ovoid mixed T2 hypo/hyper-intense focus in the periventricular white matter of the left frontal lobe. Diffuse bilateral T2 hyperintense signal in the deep and periventricular white matter of the cerebral hemispheres
Axial DWI B1000 shows 1.4 cm focus of high signal in the periventricular white matter of the left frontal lobe consistent with abnormal restricted diffusion and suspicious for an acute infarct or intraparenchymal haematoma.
Axial ADC Map confirms a focus of abnormal restricted diffusion in the periventricular white matter of the left frontal lobe, suspicious for an acute infarct or intraparenchymal haematoma.
Axial T1WI shows a hyperintense focus in the periventricular white matter of the left frontal lobe which correlates to the previously identified focus of abnormal restricted diffusion and mixed T2/FLAIR hyper/hypo-intense signal constant with an acute intraparenchymal haematoma.
Axial SWI demonstrates diffuse bilateral hypointensities consistent with microhaemorrhages in the periventricular and deep white matter of the cerebral and cerebellar hemispheres, with relative sparing of the juxtacortical white matter and brainstem. The acute left frontal intraparenchymal haematoma is also identified.
Sagittal T2WI demonstrate pronounced atrophy of the cerebellum, most marked in the vermis. Again noted is an ovoid mixed T2 hypo/hyper-intense focus in the periventricular white matter of the left frontal lobe and diffuse bilateral T2 hyperintense signal in the deep and periventricular white matter of the cerebral hemispheres.