PMC10026144_01
Left: Patient's T1 weighted sagittal MRI of the brain at 2 years and 9 months
on initial presentation to the hospital showing cerebellar volume within the
range of normal. Right: Patient's T1 weighted sagittal MRI of the brain at 3
years and 9 months demonstrating midline cerebellar vermian atrophy.
10.1177_2329048X231163944-fig1.jpg
PMC10026144_02_10.1177_2329048X231163944-fig1.jpg
fig1-2329048X231163944
However, repeat MRI at this time was concerning for cerebellar volume loss, especially in the vermis, with widening of the sulci and an increased size of the 4th ventricle and the cisterna magna compared to his baseline scan from his initial presentation (Figure 1).
Left: Patient's coronal T2 FLAIR MRI at 2 years and 9 months on initial
presentation to the hospital showing normal cerebellar volume without FLAIR
hyperintensity. Right: Patient's coronal T2 FLAIR MRI of the brain at 3
years and 9 months demonstrating hyperintensity in the superior more than
inferior bilateral portions of the cerebellar hemispheres.
10.1177_2329048X231163944-fig2.jpg
PMC10026144_02_10.1177_2329048X231163944-fig2.jpg
fig2-2329048X231163944
T2/FLAIR hyperintense signal in the cerebellum at that time (Figure 2). The pediatric neurology and neurosurgery teams agreed that there was no role for surgical intervention in this case as hydrocephalus was not a concern.
PMC10026144_02
Left: Patient's T1 weighted sagittal MRI of the brain at 2 years and 9 months
on initial presentation to the hospital showing cerebellar volume within the
range of normal. Right: Patient's T1 weighted sagittal MRI of the brain at 3
years and 9 months demonstrating midline cerebellar vermian atrophy.
10.1177_2329048X231163944-fig1.jpg
PMC10026144_02_10.1177_2329048X231163944-fig1.jpg
fig1-2329048X231163944
However, repeat MRI at this time was concerning for cerebellar volume loss, especially in the vermis, with widening of the sulci and an increased size of the 4th ventricle and the cisterna magna compared to his baseline scan from his initial presentation (Figure 1).
Left: Patient's coronal T2 FLAIR MRI at 2 years and 9 months on initial
presentation to the hospital showing normal cerebellar volume without FLAIR
hyperintensity. Right: Patient's coronal T2 FLAIR MRI of the brain at 3
years and 9 months demonstrating hyperintensity in the superior more than
inferior bilateral portions of the cerebellar hemispheres.
10.1177_2329048X231163944-fig2.jpg
PMC10026144_02_10.1177_2329048X231163944-fig2.jpg
fig2-2329048X231163944
T2/FLAIR hyperintense signal in the cerebellum at that time (Figure 2). The pediatric neurology and neurosurgery teams agreed that there was no role for surgical intervention in this case as hydrocephalus was not a concern.
PMC10026144_03