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Acute cerebellar ataxia

Case contributed by Huda B. Gharbia
Diagnosis almost certain

Presentation

History of fever one week ago, then developed headache, vomiting and sudden convulsion.

Patient Data

Age: 10 years
Gender: Female
mri

MRI reveals diffuse swelling and enlargement of left cerebellar hemisphere, which appears hypointense in T1W, hyperintense in T2W and FLAIR sequences. preserved striations. It shows restricted diffusion in DW/ADC. It causes mass effect on ipsilateral cerebellar peduncles and vermis, causing obliteration of foramen magnum, the fourth ventricle and effacement of superior cerebellar cistern, compression on the brain stem and mild supratentorial hydrocephalus.

Case Discussion

Acute cerebellar ataxia or cerebellitis is an inflammatory process of the cerebellum usually post-infectious in etiology.

On imaging features alone, one would want to consider Lhermitte Duclos disease and some variants of medulloblastoma

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