Clinical and MRI Findings in Acute Cerebellitis

Acute cerebellitis is an inflammatory syndrome characterized by cerebellar dysfunction with acute onset. Here, the clinical findings, conventional and diffusion-weighted MR imaging features of five cases are reported. The most common clinical findings were headache, vertigo, nausea and vomiting. Neurological examination revealed cerebellar ataxia, nystagmus, dysmetria and dysdiadokinesia. Analysis of the CSF showed an elevated protein content and pleocytosis. Bilateral cerebellar cortical involvement and leptomeningeal enhancement along the folia represent the most common imaging presentations. Diffusion- weighted MR imaging showed restricted diffusion in two patients. In one patient, diffusion- weighted MR imaging did not show restricted diffusion. All patients were treated medically. Additionally, external ventricular drainage was performed in one patient. Follow-up MR imaging revealed cerebellar atrophy in 1 patient and gliosis in 2 patients. Two patients completely resolved after medical therapy. In conclusion, brain MR imaging and diffusion- weighted MR imaging are valuable imaging methods in diagnosis of cerebellitis, assessment of complications and sequel lesions.