White cerebellum sign

Case contributed by Fakhry Mahmoud Ebouda
Diagnosis almost certain

Presentation

Severe head trauma in road traffic accident.

Patient Data

Age: 10 years old
Gender: Female
ct

Diffuse supratentorial hypodensity with poor grey white matter differentiation is seen involving both cerebral hemispheres. The possibility of post traumatic ischemic changes is suggested.

Further evidence of small hyper dense area is seen in right temporal region. This could represent small contusion.

Remarkable diffuse increase attenuation within both cerebellar hemispheres represents white cerebellum sign (also called reversal sign).

Case Discussion

White cerebellum sign (also called reversal sign or dense cerebellum sign) is encountered owing to direct severe head trauma during road traffic accident (RTA). This sign denotes irreversible brain damage . It has a very poor prognosis, that is why radiologists must be aware of this sign.

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