Tonsillar contusion associated with benign tonsillar ectopia following minor head trauma

Abstract

This case suggests that damage to cerebellar structures is not limited only to overt tonsillar herniation. Benign tonsillar ectopia may predispose to cerebellar contusion even after minor concussion and thus has a clinical significance. The current paradigm viewing only noticeable tonsillar herniation as a risk factor for hindbrain injury should be revisited.

Complete early regression of asymptomatic hindbrain herniation caused by minor head trauma

“…The term Chiari malformation can be criticized for being a misnomer as it typically refers to a congenital abnormality. Since it can also be acquired and reversible [1–3], the term hindbrain herniation probably describes more accurately this condition. However, mainly for communication purposes, the name Chiari malformation is frequently used in clinical practice [8].…”

“…Caudal displacement of the cerebellar tonsils into the upper cervical canal, either congenital or acquired, has previously been described [1–3]. Incidental caudal displacement of the cerebellar tonsils on Magnetic Resonance Imaging (MRI) has also been reported in asymptomatic patients or in patients with symptoms unrelated to posterior fossa involvement [2–4].…”

“…Incidental caudal displacement of the cerebellar tonsils on Magnetic Resonance Imaging (MRI) has also been reported in asymptomatic patients or in patients with symptoms unrelated to posterior fossa involvement [2–4]. Few cases of downward displacement of cerebellar tonsils in children following head trauma have been reported in the literature [1, 3–7].…”

Traumatic Transient Herniation Concomitant with Tonsillar Hemorrhagic Contusion in a Child

“…In the presented case, we observed a trauma patient with tonsillar hemorrhagic contusion concomitant with herniation. Serlin presented a case with both benign tonsillar ectopia and contusion after trauma [ 8 ].…”

“…This theory explains why the cerebellar ectopia regressed after the ongoing pathological processes ceased in follow-up. Another theory is the regression of the tonsillar herniation due to the atrophy of the tonsils in the follow-up period, as Serlin pointed out [ 8 ].…”