case_images: PMC10026144_01
case_images: Left: Patient's T1 weighted sagittal MRI of the brain at 2 years and 9 months
  on initial presentation to the hospital showing cerebellar volume within the
  range of normal. Right: Patient's T1 weighted sagittal MRI of the brain at 3
  years and 9 months demonstrating midline cerebellar vermian atrophy.
case_images: 10.1177_2329048X231163944-fig1.jpg
case_images: PMC10026144_02_10.1177_2329048X231163944-fig1.jpg
case_images: fig1-2329048X231163944
case_images: However, repeat MRI at this time was concerning for cerebellar volume loss, especially in the vermis, with widening of the sulci and an increased size of the 4th ventricle and the cisterna magna compared to his baseline scan from his initial presentation (Figure 1).
case_images: Left: Patient's coronal T2 FLAIR MRI at 2 years and 9 months on initial
  presentation to the hospital showing normal cerebellar volume without FLAIR
  hyperintensity. Right: Patient's coronal T2 FLAIR MRI of the brain at 3
  years and 9 months demonstrating hyperintensity in the superior more than
  inferior bilateral portions of the cerebellar hemispheres.
case_images: 10.1177_2329048X231163944-fig2.jpg
case_images: PMC10026144_02_10.1177_2329048X231163944-fig2.jpg
case_images: fig2-2329048X231163944
case_images: T2/FLAIR hyperintense signal in the cerebellum at that time (Figure 2). The pediatric neurology and neurosurgery teams agreed that there was no role for surgical intervention in this case as hydrocephalus was not a concern.
case_images: PMC10026144_02
case_images: Left: Patient's T1 weighted sagittal MRI of the brain at 2 years and 9 months
  on initial presentation to the hospital showing cerebellar volume within the
  range of normal. Right: Patient's T1 weighted sagittal MRI of the brain at 3
  years and 9 months demonstrating midline cerebellar vermian atrophy.
case_images: 10.1177_2329048X231163944-fig1.jpg
case_images: PMC10026144_02_10.1177_2329048X231163944-fig1.jpg
case_images: fig1-2329048X231163944
case_images: However, repeat MRI at this time was concerning for cerebellar volume loss, especially in the vermis, with widening of the sulci and an increased size of the 4th ventricle and the cisterna magna compared to his baseline scan from his initial presentation (Figure 1).
case_images: Left: Patient's coronal T2 FLAIR MRI at 2 years and 9 months on initial
  presentation to the hospital showing normal cerebellar volume without FLAIR
  hyperintensity. Right: Patient's coronal T2 FLAIR MRI of the brain at 3
  years and 9 months demonstrating hyperintensity in the superior more than
  inferior bilateral portions of the cerebellar hemispheres.
case_images: 10.1177_2329048X231163944-fig2.jpg
case_images: PMC10026144_02_10.1177_2329048X231163944-fig2.jpg
case_images: fig2-2329048X231163944
case_images: T2/FLAIR hyperintense signal in the cerebellum at that time (Figure 2). The pediatric neurology and neurosurgery teams agreed that there was no role for surgical intervention in this case as hydrocephalus was not a concern.
case_images: PMC10026144_03