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Vertebral artery dissection presenting as cerebellar infarction
  1. PETER J A HUTCHINSON,
  2. JOHN D PICKARD
  1. Department of Neurosurgery
  2. Department of Radiology, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK
  1. Mr Peter Hutchinson, Department of Neurosurgery, University of Cambridge, Box 167, Addenbrooke's Hospital, Cambridge CB2 2QQ, UK.
  1. J NICHOLAS P HIGGINS
  1. Department of Neurosurgery
  2. Department of Radiology, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK
  1. Mr Peter Hutchinson, Department of Neurosurgery, University of Cambridge, Box 167, Addenbrooke's Hospital, Cambridge CB2 2QQ, UK.

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A seven year old boy presented with a 4 day history of frontal headache, vomiting, dizziness, and tiredness. He had sustained a minor head injury 6 days before admission by falling from his bicycle. This was not associated with loss of consciousness and he initially made a full recovery. On examination, he was drowsy with no focal neurological signs and no papilloedema.

(A) Cerebral CT showing left cerebellar hemispheric low density with distortion of the fourth ventricle. There is moderate dilatation of the third (small arrow) and lateral ventricles (large arrows). (B) Axial cerebral T2 weighted MRI showing an area of high intensity involving the left cerebellar hemisphere …

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