This sagittal (from the side) T1 weighted MRI image of the brain shows severe preferential atrophy involving the superior vermis of the cerebellum. This person was a chronic alcoholic. One of the manifestions of chronic alcoholism in the brain is atrophy, which can selectively and more severely involve the superior aspect of the cerebellar vermis. Also note that the image is somewhat degraded by excessive patient motion. This person was sufferring from 'delirium tremens' withdrawal symptoms, making it difficult for them to hold still for the exam.