case_images: PMC4386114_01
case_images: a MRI diffusion-weighted imaging demonstrates stroke in the basilar artery perforator and left posterior inferior cerebellar artery territory, including the left hemi-midbrain, upper pons, and left cerebellum. b A head CT reveales evolution of a large infarct of the left cerebellum, pons, and midbrain, now involving the left red nucleus with destruction of the clivus. Diffuse marrow signal abnormality within the clivus and surrounding central skull base, with contiguous sinus disease, is seen on the axial (c) and coronal (d) orientations of CT angiography, demonstrating sinusitis, likely of fungal etiology, invading through and destroying the clivus.
case_images: crn-0007-0051-g01.jpg
case_images: PMC4386114_01_crn-0007-0051-g01.jpg
case_images: F1
case_images: MRI diffusion-weighted imaging demonstrated stroke in the basilar artery perforator and left posterior inferior cerebellar artery territory, including the left hemi-midbrain, upper pons, and left cerebellum (fig. 1a). A head CT the following day also revealed evolution of the large infarct of the left cerebellum, pons, and midbrain, now involving the left red nucleus with destruction of the clivus (fig. 1b). The diffuse marrow signal abnormality within the clivus and surrounding central skull base, with contiguous sinus disease, was also seen on the axial (fig. 1c) and coronal (fig. 1d) orientations of CT angiography (CTA), demonstrating sinusitis, likely of fungal etiology, invading through and destroying the clivus.