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The malignant mass effect was picked on an MRI scan performed routinely as part of a clinical trial, 32 hours after stroke. Our case highlights stroke evolution, and mass effect may be insidious and faster than anticipated in the posterior fossa. Cerebellar stroke of any severity diagnosed clinically and radiologically may benefit from routine follow-up imaging at 24 hours from onset.<\/jats:p>","DOI":"10.1136\/bcr-2021-243815","type":"journal-article","created":{"date-parts":[[2021,7,26]],"date-time":"2021-07-26T12:41:09Z","timestamp":1627303269000},"page":"e243815","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Early space-occupying cerebellar oedema requiring decompressive craniectomy following a clinically minor stroke"],"prefix":"10.1136","volume":"14","author":[{"given":"Branko","family":"Borojevic","sequence":"first","affiliation":[{"name":"Department of Neurosciences, Eastern Health, Box Hill, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip M C","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Eastern Health, Box Hill, Victoria, Australia"},{"name":"Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,7,26]]},"reference":[{"key":"2025082701381760000_14.7.e243815.1","doi-asserted-by":"crossref","DOI":"10.1148\/radiology.137.1.7422831","article-title":"Infarctions of the brainstem and cerebellum: a correlation of computed tomography and angiography","volume":"137","author":"Hinshaw","year":"1980","journal-title":"Radiology"},{"key":"2025082701381760000_14.7.e243815.2","doi-asserted-by":"publisher","DOI":"10.1161\/01.str.0000441965.15164.d6"},{"key":"2025082701381760000_14.7.e243815.3","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.114.008504"},{"key":"2025082701381760000_14.7.e243815.4","doi-asserted-by":"crossref","DOI":"10.3171\/2013.2.FOCUS12363","article-title":"Space-occupying cerebellar infarction: complications, treatment, and outcome","volume":"34","author":"Neugebauer","year":"2013","journal-title":"Neurosurg Focus"},{"key":"2025082701381760000_14.7.e243815.5","doi-asserted-by":"crossref","first-page":"450","DOI":"10.1016\/j.wneu.2017.10.144","article-title":"Suboccipital decompressive craniectomy for cerebellar infarction: a systematic review and meta-analysis","volume":"110","author":"Ayling","year":"2018","journal-title":"World Neurosurg"},{"key":"2025082701381760000_14.7.e243815.6","doi-asserted-by":"publisher","DOI":"10.1007\/s004150050344"},{"key":"2025082701381760000_14.7.e243815.7","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1159\/000455229","article-title":"Mri of cerebellar infarction","volume":"77","author":"De Cocker","year":"2017","journal-title":"Eur Neurol"},{"key":"2025082701381760000_14.7.e243815.8","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.31.9.2062"},{"key":"2025082701381760000_14.7.e243815.9","doi-asserted-by":"publisher","DOI":"10.3171\/2011.10.FOCUS11248"},{"key":"2025082701381760000_14.7.e243815.10","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(08)70216-3"},{"key":"2025082701381760000_14.7.e243815.11","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.25.2.372"},{"key":"2025082701381760000_14.7.e243815.12","first-page":"68","article-title":"Suboccipital decompressive surgery in cerebellar infarction","volume":"60","author":"Mohsenipour","year":"1999","journal-title":"Zentralbl Neurochir"},{"key":"2025082701381760000_14.7.e243815.13","doi-asserted-by":"crossref","DOI":"10.3389\/fneur.2020.588064","article-title":"Multimodal computed tomography increases the detection of posterior fossa strokes compared to brain Non-contrast computed tomography","volume":"11","author":"Ostman","year":"2020","journal-title":"Front Neurol"},{"key":"2025082701381760000_14.7.e243815.14","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.115.008718"},{"key":"2025082701381760000_14.7.e243815.15","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.117.018237"},{"key":"2025082701381760000_14.7.e243815.16","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.119.013069","article-title":"Incremental value of computed tomography perfusion for final infarct prediction in acute ischemic cerebellar stroke","volume":"8","author":"Fabritius","year":"2019","journal-title":"J Am Heart Assoc"},{"key":"2025082701381760000_14.7.e243815.17","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1007\/s12028-013-9886-2","article-title":"Prediction of poor outcome in cerebellar infarction by diffusion MRI","volume":"19","author":"Tchopev","year":"2013","journal-title":"Neurocrit Care"},{"key":"2025082701381760000_14.7.e243815.18","unstructured":"Stroke foundation . 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