White cerebellum sign explained

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.

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.

External resources

Web site: White cerebellum sign Radiology Reference Article Radiopaedia.org. Jha. Praveen. radiopaedia.org. en. 2017-03-26.

Notes and References

Chavhan. GB. Shroff. MM. Twenty classic signs in neuroradiology: A pictorial essay.. The Indian Journal of Radiology & Imaging. 2008. 19. 2. 135–45. 10.4103/0971-3026.50835. 19881070. 2765171 . free .
Chalela. JA. Rothlisberger. J. West. B. Hays. A. The white cerebellum sign: an under recognized sign of increased intracranial pressure.. Neurocritical Care. June 2013. 18. 3. 398–9. 10.1007/s12028-013-9836-z. 23589182. 2152985.
Han. BK. Towbin. RB. De Courten-Myers. G. McLaurin. RL. Ball WS. Jr. Reversal sign on CT: effect of anoxic/ischemic cerebral injury in children.. AJNR. American Journal of Neuroradiology. 1988. 10. 6. 1191–8. 2512781. 8332434.
Krishnan. P. Chowdhury. SR. "White cerebellum" sign - A dark prognosticator.. Journal of Neurosciences in Rural Practice. October 2014. 5. 4. 433. 10.4103/0976-3147.140015. 25288860. 4173255. free.