Presentation
Fever, headache, vomiting and postural instability.
Patient Data
There is an almost diffuse hypodensity involving the right cerebellar hemisphere causing loss of white-grey matter differentiation and minimal mass-effect on the fourth ventricle and midbrain, without calcification or hemorrhage.
There is diffuse cortical edema of the right cerebellar hemisphere which appears hypointense on T1, hyperintense on T2, FLAIR, DWI and ADC images.
This cerebellar edema causes mild compression on the right midbrain. No evidence of enhancement after contrast administration.
Case Discussion
Cerebellitis is a rare disorder which usually presents with a headache, nausea, vomiting, and ataxia.
CT scan shows diffuse right cerebellar hypodensity which is not specific, however, MRI with contrast is more reliable to narrow the differential diagnosis.
Complications such as obstructive hydrocephalus and tonsillar herniation should be considered in this entity.
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