Skip to main content
Advertisement

Main menu

  • Home
  • Content
    • Current Issue
    • Accepted Manuscripts
    • Article Preview
    • Past Issue Archive
    • Video Articles
    • AJNR Case Collection
    • Case of the Week Archive
    • Case of the Month Archive
    • Classic Case Archive
  • Special Collections
    • AJNR Awards
    • Low-Field MRI
    • Alzheimer Disease
    • ASNR Foundation Special Collection
    • Photon-Counting CT
    • View All
  • Multimedia
    • AJNR Podcasts
    • AJNR SCANtastic
    • Trainee Corner
    • MRI Safety Corner
    • Imaging Protocols
  • For Authors
    • Submit a Manuscript
    • Submit a Video Article
    • Submit an eLetter to the Editor/Response
    • Manuscript Submission Guidelines
    • Statistical Tips
    • Fast Publishing of Accepted Manuscripts
    • Graphical Abstract Preparation
    • Imaging Protocol Submission
    • Author Policies
  • About Us
    • About AJNR
    • Editorial Board
    • Editorial Board Alumni
  • More
    • Become a Reviewer/Academy of Reviewers
    • Subscribers
    • Permissions
    • Alerts
    • Feedback
    • Advertisers
    • ASNR Home

User menu

  • Alerts
  • Log in

Search

  • Advanced search
American Journal of Neuroradiology
American Journal of Neuroradiology

American Journal of Neuroradiology

ASHNR American Society of Functional Neuroradiology ASHNR American Society of Pediatric Neuroradiology ASSR
  • Alerts
  • Log in

Advanced Search

  • Home
  • Content
    • Current Issue
    • Accepted Manuscripts
    • Article Preview
    • Past Issue Archive
    • Video Articles
    • AJNR Case Collection
    • Case of the Week Archive
    • Case of the Month Archive
    • Classic Case Archive
  • Special Collections
    • AJNR Awards
    • Low-Field MRI
    • Alzheimer Disease
    • ASNR Foundation Special Collection
    • Photon-Counting CT
    • View All
  • Multimedia
    • AJNR Podcasts
    • AJNR SCANtastic
    • Trainee Corner
    • MRI Safety Corner
    • Imaging Protocols
  • For Authors
    • Submit a Manuscript
    • Submit a Video Article
    • Submit an eLetter to the Editor/Response
    • Manuscript Submission Guidelines
    • Statistical Tips
    • Fast Publishing of Accepted Manuscripts
    • Graphical Abstract Preparation
    • Imaging Protocol Submission
    • Author Policies
  • About Us
    • About AJNR
    • Editorial Board
    • Editorial Board Alumni
  • More
    • Become a Reviewer/Academy of Reviewers
    • Subscribers
    • Permissions
    • Alerts
    • Feedback
    • Advertisers
    • ASNR Home
  • Follow AJNR on Twitter
  • Visit AJNR on Facebook
  • Follow AJNR on Instagram
  • Join AJNR on LinkedIn
  • RSS Feeds

AJNR Awards, New Junior Editors, and more. Read the latest AJNR updates

Research ArticlePediatric Neuroimaging

Cerebellar Watershed Injury in Children

J.N. Wright, D.W.W. Shaw, G. Ishak, D. Doherty and F. Perez
American Journal of Neuroradiology April 2020, DOI: https://doi.org/10.3174/ajnr.A6532
J.N. Wright
aFrom the Departments of Radiology (J.N.W., D.W.W.S., G.I., F.P.)
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for J.N. Wright
D.W.W. Shaw
aFrom the Departments of Radiology (J.N.W., D.W.W.S., G.I., F.P.)
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for D.W.W. Shaw
G. Ishak
aFrom the Departments of Radiology (J.N.W., D.W.W.S., G.I., F.P.)
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for G. Ishak
D. Doherty
bPediatrics (D.D.), Divisions of Developmental and Genetic Medicine, University of Washington and Seattle Children’s Hospital, Seattle, Washington.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for D. Doherty
F. Perez
aFrom the Departments of Radiology (J.N.W., D.W.W.S., G.I., F.P.)
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for F. Perez
  • Article
  • Figures & Data
  • Info & Metrics
  • Responses
  • References
  • PDF
Loading

Article Figures & Data

Figures

  • FIG 1.
    • Download figure
    • Open in new tab
    • Download powerpoint
    FIG 1.

    Axial T2WI from patient 2 (A), parasagittal T2WI from patient 8 (B), and a coronal T2WI from patient 6 (C) demonstrate the characteristic appearance and location of cerebellar watershed injury. There is T2 prolongation greatest in the gray matter at the depths of the cerebellar fissures (white arrows) within the deep cerebellar watershed territory.

  • FIG 2.
    • Download figure
    • Open in new tab
    • Download powerpoint
    FIG 2.

    Schematic drawing of the vascular territories of the cerebellum. Note the central distribution of the cerebellar watershed areas (WSCA) at the junction of PICA, AICA, and SCA. The distribution of MR imaging signal abnormality in our case series corresponds to cerebellar watershed regions, best demonstrated by comparing the axial (B), parasagittal (E), and coronal (F) schematic images with multiplanar MR images in Fig 1. Modified from Savoiardo et al.7

  • FIG 3.
    • Download figure
    • Open in new tab
    • Download powerpoint
    FIG 3.

    Coronal T2WI from patient 4 (A, C, and E) and patient 11 (B, D, and F) demonstrates the appearance of newly developed acute (C and D) and subsequent chronic (E and F) phase injury in previously normal cerebella (A and B). White arrows highlight multipe sites demonstrating progressive development of typical watershed injury in previously normal gray matter.

  • FIG 4.
    • Download figure
    • Open in new tab
    • Download powerpoint
    FIG 4.

    Coronal T2WI (A), coronal DWI (B), and coronal ADC map (C) from patient 18 demonstrate acute cerebellar and supratentorial injury with T2 prolongation and restricted diffusion in the setting of HII. Coronal T2WI (D), coronal DWI (E), and coronal ADC map (F) from patient 9 demonstrate acute cerebellar (white arrowheads) and supratentorial (white arrows) injury without diffusion restriction in the setting of PRES.

  • FIG 5.
    • Download figure
    • Open in new tab
    • Download powerpoint
    FIG 5.

    Coronal T1WI from patient 22 in the subacute (A) and chronic (B) phases demonstrates focal T1 hyperintensity in the bilateral cerebellar watershed (white arrows in A), consistent with laminar necrosis and resolved within 1 month on follow-up (white arrows in B).

  • FIG 6.
    • Download figure
    • Open in new tab
    • Download powerpoint
    FIG 6.

    Coronal T2WI from patients during the chronic phase. Patients 1 (A) and 2 (B) demonstrate T2 prolongation with relatively marked gray matter volume loss at the sites of prior injury (white arrows). Patients 7 (C) and 10 (D) demonstrate a thick lamina of gray matter T2 prolongation centered at the depths of the cerebellar fissures in an arterial watershed distribution. See also Figs 1C, 3E, and 3F for additional examples.

  • FIG 7.
    • Download figure
    • Open in new tab
    • Download powerpoint
    FIG 7.

    Findings of both acute and remote supratentorial watershed injury in patients 1–6 (A–F, respectively). Acute watershed infarcts with signal abnormality on axial (A and B) and coronal (C) DWI in a characteristic parasagittal distribution. Subacute or remote watershed infarcts with hyperintensity and parenchymal volume loss on coronal (D and F) and axial (E) T2.

PreviousNext
Back to top
Advertisement
Print
Download PDF
Email Article

Thank you for your interest in spreading the word on American Journal of Neuroradiology.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Cerebellar Watershed Injury in Children
(Your Name) has sent you a message from American Journal of Neuroradiology
(Your Name) thought you would like to see the American Journal of Neuroradiology web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Cite this article
J.N. Wright, D.W.W. Shaw, G. Ishak, D. Doherty, F. Perez
Cerebellar Watershed Injury in Children
American Journal of Neuroradiology Apr 2020, DOI: 10.3174/ajnr.A6532

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
0 Responses
Respond to this article
Share
Bookmark this article
Cerebellar Watershed Injury in Children
J.N. Wright, D.W.W. Shaw, G. Ishak, D. Doherty, F. Perez
American Journal of Neuroradiology Apr 2020, DOI: 10.3174/ajnr.A6532
del.icio.us logo Twitter logo Facebook logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One
Purchase

Jump to section

  • Article
    • Abstract
    • ABBREVIATIONS:
    • MATERIALS AND METHODS
    • RESULTS
    • DISCUSSION
    • CONCLUSIONS
    • References
  • Figures & Data
  • Info & Metrics
  • Responses
  • References
  • PDF

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • Depth-of-Fissure Cerebellar Infarcts in Adults
  • Reply
  • Crossref
  • Google Scholar

This article has not yet been cited by articles in journals that are participating in Crossref Cited-by Linking.

More in this TOC Section

  • FRACTURE MR in Congenital Vertebral Anomalies
  • Comparing MRI Perfusion in Pediatric Brain Tumors
  • Sodium MRI in Pediatric Brain Tumors
Show more Pediatric Neuroimaging

Similar Articles

Advertisement

Indexed Content

  • Current Issue
  • Accepted Manuscripts
  • Article Preview
  • Past Issues
  • Editorials
  • Editor's Choice
  • Fellows' Journal Club
  • Letters to the Editor
  • Video Articles

Cases

  • Case Collection
  • Archive - Case of the Week
  • Archive - Case of the Month
  • Archive - Classic Case

More from AJNR

  • Trainee Corner
  • Imaging Protocols
  • MRI Safety Corner
  • Book Reviews

Multimedia

  • AJNR Podcasts
  • AJNR Scantastics

Resources

  • Turnaround Time
  • Submit a Manuscript
  • Submit a Video Article
  • Submit an eLetter to the Editor/Response
  • Manuscript Submission Guidelines
  • Statistical Tips
  • Fast Publishing of Accepted Manuscripts
  • Graphical Abstract Preparation
  • Imaging Protocol Submission
  • Evidence-Based Medicine Level Guide
  • Publishing Checklists
  • Author Policies
  • Become a Reviewer/Academy of Reviewers
  • News and Updates

About Us

  • About AJNR
  • Editorial Board
  • Editorial Board Alumni
  • Alerts
  • Permissions
  • Not an AJNR Subscriber? Join Now
  • Advertise with Us
  • Librarian Resources
  • Feedback
  • Terms and Conditions
  • AJNR Editorial Board Alumni

American Society of Neuroradiology

  • Not an ASNR Member? Join Now

© 2025 by the American Society of Neuroradiology All rights, including for text and data mining, AI training, and similar technologies, are reserved.
Print ISSN: 0195-6108 Online ISSN: 1936-959X

Powered by HighWire