A 12-year-old female neutered cat presented with peracute onset of vestibulo-cerebellar signs and severe tetraparesis. Of interest on examination, this cat was showing severe spastic ventroflexion of the neck and worsening of the cerebello-vestibular signs when the head was manually moved especially in extension. MR study of the brain showed a well-defined intra-axial lesion affecting the right side of the caudal aspect of the cerebellar vermis, involving the nodulus, uvula and tuber vermis. This lesion was homogeneous, markedly hyperintense in T2W and FLAIR, mildly hypointense in T1W, and without contrast enhancement. SWI images do not reveal the presence of intralesional haemorrhage. It was hyperintense in DWI and hypointense in ADC map, indicating restrictive diffusion. These imaging findings were consistent with an infarct in the neurovascular territory of the right caudal cerebellar artery.

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Caudal cerebellar artery infarcts are extremely rare in both dogs and cats compared to other neurovascular territories.

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The effect of lesions of the nodulus and uvula was previously reviewed:

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Courtesy of Koen Santifort, Evidensia-Arnhem