MY CONTENT

Focal signal abnormalities at the depth of the cerebellar fissures in children have been reported and hypothesized to represent a novel pattern of bottom-of-fissure dysplasia. The authors report a series of 23 patients with a similar distribution and appearance of cerebellar signal abnormality attributable to watershed injury. T2 prolongation was observed at the depths of the cerebellar fissures bilaterally in all 23 patients, centered at the expected location of the deep cerebellar vascular borderzone. Diffusion restriction was associated with MR imaging performed during acute injury in 13/16 patients. Five of 23 patients had prior imaging, all demonstrating a normal cerebellum. The etiology of injury was hypoxic-ischemic injury in 17/23 patients, posterior reversible encephalopathy syndrome in 3/23 patients, and indeterminate in 3/23 patients.