Maxwell AK, Muelleman T, Barnard Z, et al. - Researchers conducted a retrospective chart and imaging review with the aim to determine clinical symptoms, signs, and radiographic evolution of middle cerebellar peduncle (MCP) diffusion restriction (DR) abnormalities following vestibular schwannoma (VS) resection. They assessed MRI obtained on postoperative day 1 and at 3 months follow-up from patients who underwent translabyrinthine VS resection over a 2-year period (August 2017–May 2019). Of 31 patients meeting the inclusion criteria, 29% (9/31) had MRI indicating MCP DR consistent with acute ischemia. Of those, two had follow up MRI exhibiting corresponding T2 signal abnormalities consistent with cerebrovascular accident (CVA) within the MCP. Both had severe gait ataxia and dysmetria necessitating acute rehabilitation admission and significantly larger tumors. According to the findings, they recommend no necessity for intervention in asymptomatic acute MCP ischemia discovered incidentally. However, in cases with a large ischemic area and presence of symptoms, especially if an acute rehabilitation admission is required, true CVA should be suspected.