White cerebellum sign of hypoxic-ischemic brain injury

Case contributed by Dr Abhinav Ranwaka

Presentation

History of trauma.

Patient Data

Age: 7
Gender: Female

There is generalized decrease in the density of the supratentorial brain due to edema with a relatively normal cerebellum in this patient with history of trauma.

This normal cerebellum paradoxically appears dense or white, labeled as 'white cerebellum sign' and conveys bad prognosis.

Case Discussion

This is a classic case of 'white cerebellum sign' associated with severe pediatric head trauma, apart from other etiologies like non-traumatic hypoxia, status epilepticus or child abuse like 'smothering'. 

Many etiologies have been postulated like vasospasm of supraclinoid middle cerebral arteries, or preferential oxygenation of posterior circulation, during severe hypoxic insult, but certainly it reflects a global severe hypoxic response.

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Case information

rID: 34668
Published: 4th Mar 2015
Last edited: 16th Jul 2018
Inclusion in quiz mode: Included

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