Presentation
Vertigo.
Patient Data
There is a 33*37*42 mm intra-axial mass-like focal lesion involving the inferior aspect of the right cerebellar hemisphere and characterized by the internal striated appearance. It does not show mass effect or diffusion restriction.
No hydrocephalus is seen.
A few high signal foci on T2 and FLAIR sequences of subcortical and periventricular white matter of both cerebral hemispheres depict microvascular ischemic events.
Once again, there is an intra-axial mass-like focal lesion involving the inferior aspect of the right cerebellar hemisphere and characterized by the internal striated appearance. It does not show mass effect or diffusion restriction.
Case Discussion
This patient has a geographic region of high T2 signal in the right cerebellar hemisphere that has not changed in appearance at follow-up at 3 months later.
Although the intial scan suggests a subacute infarct, the lack of change raises the possibility of an alternative diagnosis such as Lhermitte-Duclos disease.
Continued follow-up is required.
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