case_images: PMC5619536_01
case_images: Action tremor seen when drawing the Archimedes' spiral.
case_images: dn-04-01-0079-g01.jpg
case_images: PMC5619536_01_dn-04-01-0079-g01.jpg
case_images: f1
case_images: He scored 20 on the Mini-mental State Examination (MMSE), a low score given his 16 years of schooling, in spite of his incapacity for drawing or writing because of the tremor (Figure 1).
case_images: Hyperintensities in both middle cerebellar peduncles seen in T2 (A) and
  in FLAIR acquisitions(B); ventricle dilatation, hyperintensities in
  periventricular white matter and in splenium of corpus callosum in
  FLAIR(C); hyperintensities in the periventricular and brain white
  matter, ventricle dilatation and brain atrophy in FLAIR (D,E); arrow
  pointing to a possible vermian infarction in FLAIR (F).
case_images: dn-04-01-0079-g02.jpg
case_images: PMC5619536_01_dn-04-01-0079-g02.jpg
case_images: f2
case_images: T2 and FLAIR white matter hyperintensities were found in both superior and infratentorial compartments, with a distinct distribution, being symmetrical in the middle cerebellar peduncles (MCP), splenium of the corpus callosum, middle pontine region and periaqueductal grey matter - and most of the bi-hemispheric white matter and periventricular regions (Figure 2). These lesions did not exhibit contrast enhancement and had no corresponding MR signal alterations on the Magnetization Transfer Contrast images.