Multiple Brainstem and Cerebellar Infarctions - Case 3

A 72 year-old man developed the acute onset of a right hemiparesis and left sided ataxia followed hours later by a severe frontal headache.

Show the Pontine Infarction               Show the Cerebellar Infarction               Show the Compression of the 4th Ventricle

Multiple Brainstem and Cerebellar Infarctions: T2-weighted axial MRIs. Note the bright signal indicating acute infarctions in the right pons and left cerebellum. Also note the compression and effacement of the fourth ventricle. On the image to the left, note that the temporal horns are dilated, indicating early hydrocephalus. Cerebellar strokes lead to edema which can result in herniation and death from direct brainstem compression or compression of the fourth ventricle and acute hydrocephalus, as in this case. This is a neurosurgical emergency, requiring immediate decompression.

Revised 11/23/06
Copyrighted 2006. David C Preston