Clinical question: Cerebellar hemorrhage. Signs and symptoms: Cerebellar hemorrhage. Nonenhanced brain MRI:No evidence of restricted diffusion on diffusion weighted studies.Examination demonstrates a focus of susceptibility/hemorrhage in the left cerebellum with subtle surrounding vasogenic edema without into change since the prior CT examination from 4 -- 24 -- 2015. Hematoma measures 9.5 x 8-mm in transaxial dimensions and without interval change or appreciable mass effect. The fourth ventricle remains within normal and in midline.Unremarkable images through posterior fossa otherwise.Images through the supratentorial space demonstrate patchy periventricular and subcortical flair/T2 hyperintensity highly suggestive of small vessel ischemic strokes of mild degree without evidence of hemorrhagic changes.Unremarkable cerebral cortex and cortical sulci as well as ventricular system and CSF spaces otherwise. The signal voids of major intracranial arterial branches are identified.Unremarkable images through the orbits, paranasal sinuses and mastoid air cells. Paranasal sinuses are well pneumatized however a retention cyst in the left maxillary sinus is noted. Bilateral mastoid air cells and there cavities demonstrate normal pneumatization signal patterns.Nonenhanced brain MRA: Patent bilateral intracranial vertebral arteries, bilateral pedicle branches, plaster are free and its distal branches. Mild atherosclerotic disease of right vertebral artery without significant vascular lumen compromise is noted.Patent right internal carotid artery however but it is some mild atherosclerotic disease of the cavernous segment and unremarkable otherwise. Patent right anterior and middle cerebral arteries and their branches. Mild atherosclerotic irregularity of the M1 segment of right middle cerebral artery is noted.Patent left internal carotid artery across the skull base however with mild atherosclerotic irregularity of its cavernous portion. Unremarkable left supraclinoid internal carotid, the left anterior and middle cerebral arteries.
1.Left cerebellar acute hematoma measuring 9.5 x 8-mm with subtle surrounding vasogenic edema and no appreciable mass-effect. Mild chronic nonhemorrhagic small vessel ischemic strokes only in the subcortical and periventricular white matter of cerebral hemispheres. 2.Mild atherosclerotic disease of the bilateral cavernous carotids and right vertebral artery without significant vascular lumen compromise and unremarkable nonenhanced brain MRI otherwise.