Cerebellar Lesions

-All lesions occurs in the supra tentorial area can be seen also in the cerebellum such as:

1-Hemorrhage.

2-Infarction.                                  HIT CC

3-Tumors.

4-Calcification.

5-Cysts.

-Infarction could be due to PICA(posterior inferior cerebellar artery) if seen in the cerebellum in its inferior part and AICA(anterior inferior cerebellar artery) if seen in the cerebellum in its superior part.

-Cerebellar abscess: the most common cause here is the ear infection of the patient while that occurs in the supra tentorial area is from infection of frontal sinuses.

-Cerebellar tuberculoma: multiple, calcified.

-Empyema: Fluid collection in the area of the dura with peripheral enhancement + containing air.

-Tumors:

1-Meningioma.

2-Pilocytic astrocytoma which is a low grade type with age incidence 5-15 years and characterized by a cyst withe enhancing nodule and rim enhancement. Contrast could diffuse inside the cyst causing fluid level.

Causes of fluid level inside cyst of the tumor are

*Diffusion of the contrast as mentioned above.

*Hemorrhage inside the cyst.

3-Hemangioblastoma(less common in children):

*10-20% associated with VHL syndrome.

*Is a vascular tumor.

*Is exactly similar to the pilocytic astrocytoma.

*Is less less common in children while pilocytic astrocytoma is most common occurs in children.

*Affects the cerebellar hemispheres in 85% and in the spinal cord in 15% and usually it does not seen in the supra tentorial area.

*How can you discriminate hemangioblastoma from pilocytic astrocytoma.

 By age as mentioned above the age in the former is in adult in middle age 30-60 years while in the latter is in children.

By vascularity in which the former characterized by a very vascular nodule appears in angiogram as a vascular blush while in the latter is not very vascular.

By multiplicity where the former can be multiple while the latter is not(very rare).

D.D.of Cerebellar Masses.