18. Isolated infarction of the tonsil in the cerebellum

Article type: Neuroimage
Article title: Isolated infarction of the tonsil in the cerebellum

Journal: Neurology India
Year: 2019
Authors: Jamir Pitton Rissardo, Ana Letícia Fornari Caprara
E-mail: jamirrissardo@gmail.com

ABSTRACT
A 62-year-old male presented with rotatory vertigo and nausea within 1 day of onset. The subject reported that these symptoms began 3 months ago, were recurrent, and lasted approximately 1 min. However, he only sought medical assistance this time because the symptoms did not improve. His medical history included hypertension, aortic valve replacement, and smoking. The neurological examination showed severe truncal and gait ataxia, normal head impulse test, negative skew deviation, gazeevoked nystagmus when looking to the side of the lesion, and right truncal lateropulsion. In addition, when the subject was walking with assistance after two steps, he veered to the opposite direction of the lesion. Laboratory tests were within normal limits. A cranial noncontrast computed tomography (CT) scan and a brain magnetic resonance imaging (MRI) revealed a lesion in the cerebellar vermis. A cranial CT angiography exhibited mild stenosis of the bilateral vertebral arteries.
Key-words: Infarction, stroke, tonsil, cerebellum

Full text available at:

DOI
10.4103/0028-3886.253573

Citation
Rissardo JP, Caprara AL. Isolated infarction of the tonsil in the cerebellum. Neurol India 2019;67:326–328

Figure 1. Neuroimages showing left-sided caudal cerebellar vermis infarction (indicated by the arrows). Axial (a) coronal (b), and sagittal (c) views of cranial noncontrast CT scan. Sagittal (d); axial noncontrast (e), and axial contrast enhancement (f); T2-weighted; coronal (g); T1-weighted axial (h); sagittal fluid-attenuated inversion recovery (i); axial diffusion-weighted (j); and, axial apparent diffusion coefficient views of brain MRI (k).

Table 1. Reported cases of subjects with infarction of the tonsil in the cerebellum.