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Acute cerebellitis with hydrocephalus

Nida Amjad1, Anwarul Haque1, Khalid Ahmed1

  • 1Department of Paediatrics, The Aga Khan University Hospital, Karachi.

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
|June 8, 2014
PubMed

Insights

This case study highlights cerebellitis in an 8-year-old, presenting with sudden headache and vomiting. Prompt treatment with corticosteroids and an external ventricular drain led to a full recovery without neurological deficits.

Area of Science:

  • Pediatric Neurology
  • Neuroimaging
  • Pediatric Infectious Diseases

Background:

  • Cerebellitis is an uncommon inflammatory condition of the cerebellum, often presenting with acute neurological symptoms in children.
  • Hydrocephalus can be a serious complication of cerebellitis, necessitating prompt diagnosis and management.
  • Understanding the neuroimaging characteristics of cerebellitis is crucial for timely intervention.

Observation:

  • An 8-year-old child presented with sudden onset headache, vomiting, broad-based gait, and intention tremors.
  • Cerebellar swelling with mass effect obliterating the fourth ventricle was observed on MRI brain.
  • CT head revealed prominent third and lateral ventricles, indicating obstructive hydrocephalus.

Findings:

  • MRI demonstrated isointense signals on T1-weighted and hyperintense signals on T2-weighted imaging in the cerebellum.
  • Clinical and radiologic findings were consistent with cerebellitis complicated by hydrocephalus.
  • The patient required high-dose corticosteroids and external ventricular drain (EVD) insertion for management.

Implications:

  • Early diagnosis and aggressive management of cerebellitis with hydrocephalus are critical for favorable outcomes in pediatric patients.
  • This case underscores the importance of neuroimaging in identifying cerebellar inflammation and associated complications.
  • Prompt treatment can prevent long-term neurological deficits, as demonstrated by the patient's uneventful recovery.

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