White cerebellum 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.


It is associated with:


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
Share article

Article information

rID: 17586
Section: Signs
Tag: signs, refs
Synonyms or Alternate Spellings:
  • Reversal sign
  • Dense cerebellum sign

Support Radiopaedia and see fewer ads

Cases and figures

  • Drag
    Case 1
    Drag here to reorder.
  • Drag
    Case 2
    Drag here to reorder.
  • Drag
    Case 3
    Drag here to reorder.
  • Drag
    Case 4
    Drag here to reorder.
  • Drag
    Case 5
    Drag here to reorder.
  • Drag
    Case 6
    Drag here to reorder.
  • Updating… Please wait.

    Alert accept

    Error Unable to process the form. Check for errors and try again.

    Alert accept Thank you for updating your details.