Bilateral hyperintense areas on T2/FLAIR and ADC and DWI show an acute infarction involving bilateral cerebellar hemispheres at the territory of posterior inferior cerebellar arteries.
A small area of altered signal is noted in the right internal capsule, which may indicate old ischemic insult.
Bilateral periventricular white matter hyperintense foci are noted, likely indicating chronic white matter ischemic changes.
No evidence of haemorrhage, mass or midline shift.
Normal ventricular system, basal cistern, Sylvian fissures, and convexity sulci.
MRA:
- the right posterior inferior cerebellar artery is not visualized, but there is a well developed left posterior inferior cerebellar artery arising from the left vertebral artery (seen in 3D and axial source images of the time-of-flight MRA)
- a well developed right anterior inferior cerebellar artery and moderately developed left one
- patency of both vertebral, basilar, posterior cerebral, and both superior cerebellar arteries
- the internal carotid arteries and their branches are normal in appearance
- there is no evidence of narrowing, dissection, irregularity, aneurysm or occlusion
MRV shows a normal flow signal noted in the superior sagittal, straight, transverse and sigmoid sinuses bilaterally, denoting patency. Normal course and calibre of internal cerebral veins, as well as vein of Galen.