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White cerebellum sign

Last revised by Craig Hacking ◉ on 2 Jan 2025

Citation, DOI, disclosures and article data

Citation:

Hacking C, Walizai T, Jones J, et al. White cerebellum sign. Reference article, Radiopaedia.org (Accessed on 22 Jan 2025) https://doi.org/10.53347/rID-17586

DOI:

https://doi.org/10.53347/rID-17586

Permalink:

https://radiopaedia.org/articles/17586

rID:

17586

Article created:

27 Apr 2012, Praveen Jha

Disclosures:

At the time the article was created Praveen Jha had no recorded disclosures.

View Praveen Jha's current disclosures

Last revised:

2 Jan 2025, Craig Hacking ◉

Disclosures:

At the time the article was last revised Craig Hacking had the following disclosures:

Philips Australia, Paid speaker at Philips Spectral CT events (ongoing)

These were assessed during peer review and were determined to not be relevant to the changes that were made.

View Craig Hacking's current disclosures

Revisions:

26 times, by 18 contributors - see full revision history and disclosures

Systems:

Central Nervous System

Sections:

Signs

Tags:

signs, refs

Synonyms:

Dense cerebellum sign
Reversal sign

White cerebellum sign, also called reversal sign or dense cerebellum sign, is encountered when there is a diffuse decrease in density of the supratentorial brain parenchyma, with relatively increased attenuation of the thalami, brainstem and cerebellum. This sign indicates irreversible brain damage and has a very poor prognosis, which is why radiologists must be aware of this sign ².

Epidemiology

It is associated with multiple causes of hypoxic-ischemic encephalopathy:

Pathology

There are different theories proposed for this sign:

raised intracranial pressure causes partial venous obstruction resulting in distension of deep medullary veins
preferential flow to posterior circulation
transtentorial herniation partially relieving the increased intracranial pressure and thus increase perfusion of central structures

References

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