Presentation
Bilateral hearing loss with ataxia.
Patient Data
Bilateral and extensive low signal regions with blooming artifacts on the GE sequence lining the surface of the cerebellum (mainly the cerebellar vermis and folia), brainstem and cerebral hemispheres (meninges and CSF spaces) in keeping with susceptibility artifacts from hemosiderin deposits with associated cerebellar atrophy.
A thin rim of low signal (hemosiderin deposits) is noted along the surface of the spinal cord mainly at the cervical region well-demonstrated on axial T2.
Case Discussion
The MRI features are most consistent with superficial siderosis, which is usually the result of recurrent occult subarachnoid bleeds although the source of bleeding is not usually identified on imaging as in this case and about 46% of cases are of idiopathic origin.
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