PMC3401656_01
Axial T2-W image shows a swollen left cerebellar hemisphere with hyperintense signal
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F1
T1-weighted images, hyperintense on T2-weighted images [Figure 1], and Fluid-Attenuated Inversion Recovery (FLAIR)- weighted images. There was a significant mass effect over the fourth ventricle and the brainstem with ascending transtentorial herniation and hydrocephalous.
Axial FLAIR image shows regression of swelling with residual hyperintense signal in the affected cerebellar hemisphere
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F2
Neurological status gradually improved and repeat contrast-enhanced MRI performed three weeks after admission revealed a decrease in the swelling and mass effect of the left cerebellar hemisphere, without significant atrophy [Figure 2].
Contrast-enhanced T1-W image shows pial enhancement
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F3
Signal abnormalities were much less severe and mild pial enhancement was noted in post-contrast images [Figure 3].
(a) Axial Gradient Recalled Echo (GRE) image shows areas of blooming in left cerebellar hemisphere (arrow). (b) Axial GRE image show subtle areas of blooming in the right cerebellar hemisphere (arrows)
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F4
T1 hyperintensity showing blooming on Gradient Recalled Echo (GRE) images were seen in the affected cerebellum as well as in the contralateral cerebellar hemisphere [Figure 4]. The patient completely recovered and was discharged 4 weeks after admission.