White cerebellum sign of hypoxic-ischemic brain injury

Case contributed by Dr Ian Bickle

Presentation

Out of hospital arrest. Intubated.

Patient Data

Age: 26
Gender: Female

Reversal of normal attenuation of the supra and infratentorial brain - the cerebellum is denser ('white').

Loss of grey-white matter differentiation in the cerebral hemispheres.

Effacement of basal cisterns and sulci.

Impression of blood in the basal cisterns - pseudosubarachnoid hemorrhage.

Case Discussion

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.

One of the commonest causes is cerebral anoxia, typically from a prolonged cardiac arrest.

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Case information

rID: 37236
Published: 30th May 2015
Last edited: 16th Jul 2018
Inclusion in quiz mode: Included

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