Cerebellar cleft: confirmation of the neuroimaging pattern

Area of Science:

• Neuroimaging
• Pediatric Neurology
• Developmental Neuroscience

Background:

• Cerebellar clefts are a rare neurodevelopmental anomaly.
• Previous research suggested a link between cerebellar clefts and prenatal cerebellar hemorrhage.
• Further investigation is needed to understand the etiology and spectrum of cerebellar clefts.

Purpose of the Study:

• To analyze the clinical and neuroimaging findings in a new series of patients with cerebellar clefts.
• To further investigate the association between cerebellar clefts and cerebellar hemorrhage, both prenatal and neonatal.
• To characterize the neuroimaging patterns and associated abnormalities in children with cerebellar clefts.

Main Methods:

• Retrospective analysis of clinical and neuroimaging data from 9 pediatric patients with cerebellar clefts.
• Detailed examination of MRI findings, including cleft location, associated structural abnormalities, and gray/white matter junction.
• Correlation of neuroimaging findings with gestational age, history of cerebellar hemorrhage, and clinical outcomes.

Main Results:

• Cerebellar clefts were observed in various locations, including unilateral and bilateral involvement.
• Associated neuroimaging findings included disordered folia/fissures, irregular gray/white matter junction, and abnormal white matter arborization.
• Prenatal cerebellar hemorrhage was implicated in most cases, with rare instances linked to neonatal hemorrhages in preterm infants.
• Supratentorial abnormalities were present in 4 cases.

Conclusions:

• Cerebellar clefts typically represent disruptive changes resulting from prenatal cerebellar hemorrhage.
• Neonatal cerebellar hemorrhages in preterm infants can exceptionally lead to cerebellar clefts.
• The neuroimaging pattern of cerebellar clefts is distinct, often accompanied by other brain anomalies.
• Short-term outcomes for affected children are variable.