Sagittal T1, axial T1, and axial T2WI show a hypointense coating of the brainstem and cerebellum. Note the increased conspicuity of this coating on the T2WI due to local dephasing from hemosiderin (blooming). Moderate vermian atrophy is present as well.
Superficial siderosis results from chronic hemorrhage in the subarachnoid space leading to coating of the brain surfaces with hemosiderin. Although some cases may be associated with tumors such as hemangioblastoma, the offending lesion is rarely identified. Cerebellar atrophy is commonly associated with this condition.
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