Female, 60 years old, with dysarthria and gait disorder. Evaluate for cerebellar disease. One or two curvilinear, nonspecific foci of T2 hyperintensity are seen within the subcortical white matter of the right superior parietal lobule. No other focal lesions are detected. No edema or mass effect is observed. There are no diffusion restricting lesions. Cerebral volume is generally well preserved. However, the cerebellar fissures are disproportionately prominent, particularly along the vermis, suggesting underlying volume loss. The brainstem is within normal limits. No evidence of intracranial hemorrhage or any abnormal extra-axial fluid is seen. The ventricular system is within normal limits.
Prominence of the cerebellar fissures, predominantly along the vermis, is out of proportion to sulcal caliber elsewhere and likely reflects underlying volume loss. The etiology for this finding is broad and includes inherited disorders, medication effect, toxic exposures and metabolic abnormalities. 