A  51-year-old female who developed bilateral [[cerebellar hemorrhage]]s following [[opioid]] and [[benzodiazepine]] overdose. [[Malignant cerebellar edema]] is a rare but recognized complication following opiate overdose in children or chronic [[heroin]] toxicity. However, acute cerebellar involvement is rarely reported in adults. 
Ahmed et al. feel that clinicians and radiologists should keep in mind the possibility of opioid toxic [[encephalopathy]] in their differential for adults with acute bilateral cerebellar infarctions and/or hemorrhages
((Ahmed U, Wilson R, Hung SC. Bilateral cerebellar [[hemorrhagic infarct]]s as an early presentation following [[opioid]]-induced toxic encephalopathy in an adult patient. Radiol Case Rep. 2021 Mar 20;16(5):1207-1210. doi: 10.1016/j.radcr.2021.02.073. PMID: 33815643; PMCID: PMC8010571.))