Presentation
Sudden onset right leg weakness, ataxia and vertigo. AF on aspirin.
Patient Data
Stroke MRI - DWI/ADC only
There is an area of restricted diffusion consistent with acute infarction within the right cerebellum and right occipital lobe. The right cerebellar infarct demonstrates peripheral restricted diffusion without restriction in the central infarct suggesting interval hemorrhage. Non-contrast CT is recommended for confirmation.
Progressive hypodensity in the right cerebellar hemisphere and right occipital lobe is in keeping with acute infarction. Parenchymal hemorrhage measuring has developed in the superior right cerebellar hemisphere within the infarct since the initial CT. Mass effect in the posterior fossa causes minor leftward midline shift and partial effacement of the fourth ventricle. No hydrocephalus or herniation.
The tip of the basilar artery appears hyperdense on thick slices (less conspicuous on thin slices), unchanged in appearance compared to the previous CT (at which time the basilar artery was patent on CTA).
Case Discussion
An example of the evolution of an infarct occurring in front of our eyes.
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