A 72 year old man developed the acute onset of a left hemiparesis and ataxia followed hours later by a severe frontal headache.
Axial T2-weighted MRI scans. Note the high signals 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 hydrocephalus. Cerebellar strokes can result in herniation and death from direct brainstem compression or compression of the fourth ventricle and acute hydrocephalus.
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