White cerebellum sign
The white cerebellum sign, also known as reversal sign or dense cerebellum sign, is a radiological sign denoting the relatively white appearance of the cerebellum due to a generalized decrease in density of the supratentorial brain structures caused by extensive edema.[1]
Causes
White cerebellum sign can be associated with raised intracranial pressure[2] that occurs due to anoxic or ischemic changes in the brain.[3] It can be found in:
- Birth asphyxia
- Status epilepticus
- Bacterial meningitis
- Encephalitis
- Severe head trauma
- Post-cardiac arrest hypoxia
- Drowning
Pathophysiology
Diffuse brain edema is the likely cause of this radiological change observed in CT or MRI.[2]
Prognosis
It was considered to indicate a bad prognosis.[4] However, evidence suggests that it could be a non-specific indicator of diffuse brain edema which might not be as ominous as previously thought.[2]
References
- ^ Chavhan, GB; Shroff, MM (2008). "Twenty classic signs in neuroradiology: A pictorial essay". The Indian Journal of Radiology & Imaging. 19 (2): 135–45. doi:10.4103/0971-3026.50835. PMC 2765171. PMID 19881070.
{{cite journal}}
: CS1 maint: unflagged free DOI (link) - ^ a b c Chalela, JA; Rothlisberger, J; West, B; Hays, A (June 2013). "The white cerebellum sign: an under recognized sign of increased intracranial pressure". Neurocritical Care. 18 (3): 398–9. doi:10.1007/s12028-013-9836-z. PMID 23589182. S2CID 2152985.
- ^ Han, BK; Towbin, RB; De Courten-Myers, G; McLaurin, RL; Ball WS, Jr (1988). "Reversal sign on CT: effect of anoxic/ischemic cerebral injury in children". AJNR. American Journal of Neuroradiology. 10 (6): 1191–8. PMC 8332434. PMID 2512781.
- ^ Krishnan, P; Chowdhury, SR (October 2014). ""White cerebellum" sign - A dark prognosticator". Journal of Neurosciences in Rural Practice. 5 (4): 433. doi:10.4103/0976-3147.140015. PMC 4173255. PMID 25288860.
{{cite journal}}
: CS1 maint: unflagged free DOI (link)
External resources
Jha, Praveen. "White cerebellum sign | Radiology Reference Article | Radiopaedia.org". radiopaedia.org. Retrieved 2017-03-26.