Unusual Cause of White Cerebellum

Sharawat, Indar Kumar; Kesavan, Shivan; Subramani, Vignesh; Vyas, Sameer; Sahu, Jitendra Kumar; Saini, Lokesh

doi:10.1007/s12098-017-2590-z

Cited by 3 publications

(4 citation statements)

References 4 publications

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“…Contrary to the common belief, one of our AFCE patients had a good outcome, just as described in three previous cases. 9,20,21 EEG in all cases showed multifocal epileptiform discharges with occasional generalization in our study. No cases of electrocortical silence or burst suppression was encountered, since we did not perform the test in the acute stage.…”

Section: Discussionsupporting

confidence: 67%

“…Contrary to the common belief, one of our AFCE patients had a good outcome, just as described in three previous cases. 9 20 21…”

Section: Discussionmentioning

confidence: 99%

“…The causes are meningoencephalitis, acute cerebellitis, status epilepticus, severe head trauma, and hypoxia induced by cardiac arrest, birth asphyxia, drowning, or nonaccidental trauma by smothering/strangulation. [7][8][9][10] These infrequent radiological signs are more common among children and are associated with adverse outcomes, including mortality in one-third cases and diffuse brain atrophy or cystic encephalomalacia in the survivors. 10,11 Previously, Lan et al 12 and Krishnan et al 1 explored the differences among pediatric encephalitis patients with and without AFCE.…”

Section: Introductionmentioning

confidence: 99%

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The Clinical, Radiological, and Electrophysiological Profile of Children Presenting with Acute Fulminant Cerebral Edema Due to Suspected Encephalitis in an Eastern Indian Tertiary Care Center

Das

Ray

Mondal

et al. 2022

Journal of Pediatric Neurology

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Objective Our objective was to describe the clinicodemographic, laboratory, and outcome profiles of a rare phenotype of pediatric acute encephalitis syndrome (AES) with acute fulminant cerebral edema (AFCE) and compare them with that of AES without AFCE. Methods We retrospectively analyzed medical records of a cluster of children hospitalized with encephalitis between June 1, 2021 and December 31, 2021. Their clinical and demographic features, laboratory investigations (hematological, biochemical, serological, microbiological, radiological, and electrophysiological tests), and follow-up data up to 3 months postdischarge were recorded. Patients with AFCE and those without it were divided into groups A and B, respectively, and their characteristics were compared. Results There were 11 and 15 patients in groups A and B, respectively. There were no significant differences between the two groups in terms of sex, neurological status at admission, hematological and cerebrospinal fluid values, pediatric intensive care unit (PICU) course, and management, etiological identification, and mortality and disabilities at discharge. Patients having reversal or having white cerebellar signs did not significantly differ in their outcomes. However, the patients in group A had significantly lower age, higher incidence of abnormal findings on head computed tomography scans at admission, longer duration of hospitalization, and neurological sequelae at 3 months. The numbers of patients with identified etiologies were zero in group A but five in group B (two Japanese encephalitis, two scrub typhus, and one dengue). Patients of group A had bilateral asymmetric temporal-parieto-occipital T2 hyperintense lesions in magnetic resonance imaging, whereas patients of group B had bifrontal predominant or thalamo-mesencephalic lesions. Multifocal epileptiform discharges were seen in electroencephalogram in both groups, which reverted to normal in 9 and 46% in groups A and B at 3 months, respectively. Conclusion Younger age is a significant risk factor for the development of AFCE in pediatric AES. AFCE patients have worse outcomes at 3 months, although they do not significantly differ from their non-AFCE counterparts at discharge. When occurring in clusters, AFCE patients exhibit the same radiological and electroencephalographic features.

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Section: Discussionsupporting

confidence: 67%

“…Contrary to the common belief, one of our AFCE patients had a good outcome, just as described in three previous cases. 9 20 21…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The Clinical, Radiological, and Electrophysiological Profile of Children Presenting with Acute Fulminant Cerebral Edema Due to Suspected Encephalitis in an Eastern Indian Tertiary Care Center

Das

Ray

Mondal

et al. 2022

Journal of Pediatric Neurology

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“…On the other hand, it is worth remembering that one of the rare cases of the white cerebellum sign may be inflammation, such as acute cerebellitis. Therefore, there are some cases, which have been described, when a quick diagnosis and implementation of causal treatment give very good therapeutic effects [6].…”

Section: Discussionmentioning

confidence: 99%

The “White Cerebellum Sign” after cardiac arrest

Janiszewska

Lewandowska²,

Nadolska³

2022

Medical Research Journal

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The white cerebellum sign, or reversal sign, is a rare radiological image in computed tomography of the head characterized by a hypodense image of the cerebral hemispheres with loss of white and gray matter differentiation and a relatively hyperdense image of infratentorial structures. It occurs in patients with severe, often irreversible, cerebral hypoxia. In the presented case of an 82-year-old patient with numerous comorbidities, the sign appeared about a week after successful cardiac arrest resuscitation. Despite intensive therapeutic management, the patient's condition could not be improved, and palliative care was initiated.

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