nature
  • 60yo M with
    • hx vertigo
    • presented to OSH for
      • dizziness, vomiting, and left facial droop.
      • CT/CTA showed L vertebral artery narrowing and
      • large L cerebellar infarct with
      • mass effect on 4th ventricle and hydrocephalus.
      • Progressive somnolence
      • requiring intubation and
      • given hyperosmolar therapy.
      • Underwent s/p decompressive suboccipital craniectomy and R frontal EVD placement
      • Course complicated by
        • vasogenic edema,
        • LLE DVT (IVC filter placed ),
        • ventilatory/oxygenation issues,
  • CT
    • Large posterior circulation infarction with
    • marked mass effect within the posterior fossa and
    • crowding of the basal cisterns and foramen magnum.
    • Linear areas of hyperdensity within the left posterior fossa
    • likely consistent with hemorrhagic conversion.
    • Dilatation of the third and lateral ventricle secondary to obstructive hydrocephalus.
Hemorrhagic cerebellar infarct, non cardiogenic pulmonary edema
001 60 head CT
Ashley Davidoff TheCommonVein.net
Hemorrhagic cerebellar infarct non cardiogenic pulmonary edema
001b 60 head CT
Ashley Davidoff TheCommonVein.net
Hemorrhagic cerebellar infarct non cardiogenic pulmonary edema
002 60 head CXR
Ashley Davidoff TheCommonVein.net
  •  MRI
    • Postprocedural changes from a since removed right frontal approach EVD catheter
    • There remains a small amount of blood products within the bilateral posterior horns and fourth ventricle.
    • Numerous areas of SWI artifact within the left cerebellum consistent with residual blood products from known left cerebellar hemorrhage.
    • There remains effacement of the left ambient cistern from the left cerebellar edema.
    • The ventricles are overall similar to minimally increased in size
    • Hemorrhagic cerebellar infarct non cardiogenic pulmonary edema 003a 60 MRI SWI
      Ashley Davidoff TheCommonVein.net
      Hemorrhagic cerebellar infarct non cardiogenic pulmonary edema 003b 60 MRI SWI
      Ashley Davidoff TheCommonVein.net
      Hemorrhagic cerebellar infarct non cardiogenic pulmonary edema 003c 60 MRI SWI
      Ashley Davidoff TheCommonVein.net

      Follow Up CXR 2 weeks later

Follow Up CXR 2 weeks later shows significant improvement of non cardiogenic pulmonary edema following acute left sided cerebellar hemorrhage
Ashley Davidoff TheCommonVein.net