Presentation
Headache, ataxia and blurred vision
Patient Data
Age: 20 years
Gender: Female
From the case:
Lhermitte-Duclos disease
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Striated appearance of the cerebellum with hyperintense signal in T2 and FLAIR and associated mild hydrocephalic changes and mild tonsillar herniation. DWI reveals increased signal which is the same in ADC map (not present here) denoting T2 shine through effect.
Case Discussion
Diagnosis: Dysplastic cerebellar gangliocytoma (Lhermitte-Duclos disease) by MRI features.
Differential diagnosis of this case includes:
- cerebellar infarction: excluded by DWI
- acute cerebellitis: excluded by clinical picture
- rhombencephalosynapsis: excluded as cerebellar vermis is present
The patient was referred for upper and lower GI endoscopy searching for polyps as this condition is associated with Cowden syndrome.