Pseudotumoral hemicerebellitis with hemorrhage

Area of Science:

• Neurology
• Pediatric Neurology
• Neuroradiology

Background:

• Acute cerebellitis is an inflammatory condition affecting the cerebellum, typically seen in children.
• It is usually bilateral and caused by various triggers.
• Pseudotumoral hemicerebellitis represents an unusual unilateral form, clinically and radiologically resembling a tumor.

Observation:

• Magnetic resonance imaging (MRI) findings include diffuse swelling of one cerebellar hemisphere.
• Key MRI features are the absence of a defined mass, T2 hyperintensity, and pial enhancement post-contrast.
• The case involved a 12-year-old boy with coagulopathy, presenting with subsequent hemorrhage on follow-up MRI.

Findings:

• Pseudotumoral hemicerebellitis is characterized by unilateral cerebellar swelling without a distinct mass on MRI.
• The condition typically exhibits a benign clinical course with spontaneous regression on serial imaging.
• Distinguishing this entity from actual tumors is vital for appropriate clinical decision-making.

Implications:

• Accurate diagnosis of pseudotumoral hemicerebellitis can prevent misdiagnosis and unnecessary surgical interventions.
• Understanding its imaging characteristics aids in differentiating it from neoplastic or other space-occupying lesions.
• This rare condition highlights the importance of considering inflammatory mimics in pediatric cerebellar lesions.