Demographics:
35 years old, Male
Indication:
Follow-up, known occlusion of the right vertebral arter...
Follow-up, known occlusion of the right vertebral artery
Findings
- Hypoattenuation and loss of gray-white differentiation in the right cerebellar hemisphere extending into the vermis
- Right cerebellar tonsillar herniation with crowding of the foramen magnum
- Upward transtentorial herniation of the vermis with effacement of the basal cisterns and fourth ventricle
- Dilation of the lateral and third ventricles with associated periventricular hypoattenuation
- Fluid layering in the nasal cavity and nasopharynx
Diagnosis
Tonsillar and upward transtentorial herniation
Sample Report
Evolving large infarct in the right cerebellar hemisphere extending into the vermis. Associated cytotoxic edema results in right cerebellar tonsillar herniation with crowding of the foramen magnum as well as upward transtentorial herniation of the vermis with effacement of the basal cisterns and fourth ventricle.
Dilation of the lateral and third ventricles with associated periventricular hypoattenuation compatible with acute obstructive hydrocephalus with subependymal edema.
Fluid layering in the nasal cavity and nasopharynx likely relates to the indwelling support apparatus.
Discussion