The “White Cerebellum Sign”, a Striking Computed Tomography Scan Finding in a Critically Ill Infant: A Case Report

Abstract

The “white cerebellum sign” is a striking neuroradiological finding, resulting from diffuse hypodense brain lesions in both cerebral hemispheres while sparing the cerebellum. This indicates widespread ischemic damage or expanded cerebral edema associated with the loss of white-gray matter differentiation. It is commonly reported in pediatric cases with severe neurological conditions, usually resulting in a poor prognosis. We present a case of a three-month-old female infant who was managed for confirmed acute bacterial meningitis complicated by status epilepticus, where the Computed tomography scan (CT scan) showed the “white cerebellum sign” in relation to diffuse cerebral hypoxic-ischemic lesions. However, the patient had a favorable outcome following treatment. This case underscores the importance of early recognition in cases presenting with the “white cerebellum sign”. It highlights the potential for a positive prognosis even in severe neurological conditions when appropriate interventions are promptly administered.

Keywords:

• white cerebellum sign
• CT scan
• meningitis
• case report

Abbreviations

CBC, Complete Blood Count; CSF, Cerebrospinal Fluid; CT-Scan, Computed Tomography Scan; GWD, Grey-white difference; HB, Haemoglobin; HTC, Haematocrit; kg, kilogram; mg, Milligram; MRI, Magnetic resonance imaging; pGCS, Pediatric Glasgow Coma Scale; WBC, White Blood Cells.

Data Sharing Statement

All data generated or analyzed during this study are included in this case report.

Ethical Approval

Not applicable. The institutional approval was not required.

Patient Consent and Right of Anonymity

The parental informed consent for publication was obtained.

Disclosure

The authors report no conflicts of interest in this work.