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Published on: November 6, 2019
Tonsillar contusion associated with benign tonsillar ectopia following minor head trauma
Yonatan Serlin1, Mony Benifla2, Ilan Shelef3
1The Laboratory for Experimental Neurosurgery, Department of Physiology and Cell Biology, Zlotowski Center for Neuroscience, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, 8410501, Israel. serliny@post.bgu.ac.il.
Even minor head injuries can cause cerebellar contusion in toddlers with benign tonsillar ectopia. This finding suggests that noticeable tonsillar herniation is not the only risk factor for hindbrain injury.
Area of Science:
- Neurology
- Radiology
- Pediatric Traumatology
Background:
- The link between tonsil position and symptomatic cerebellar contusion remains unclear.
- Existing literature primarily focuses on Chiari malformations (tonsillar displacement ≥5 mm) as a cause of hindbrain injury.
- Symptomatic traumatic brain injury linked to benign tonsillar ectopia has not been previously reported.
Observation:
- A case study of a toddler experiencing a symptomatic concussion with an incidental finding of benign tonsillar ectopia.
- Unusual computerized tomography (CT) findings revealed hemorrhagic contusion of the cerebellar tonsils.
- Magnetic resonance imaging (MRI) studies demonstrated blood-brain barrier (BBB) disruption and delayed atrophy.
Findings:
- Benign tonsillar ectopia, not just overt herniation, can predispose individuals to cerebellar contusion.
- Cerebellar structures may be damaged even after minor head trauma in cases of benign tonsillar ectopia.
- The study highlights the clinical significance of benign tonsillar ectopia in pediatric head injuries.
Implications:
- The current understanding of hindbrain injury risk factors needs reevaluation.
- Clinicians should consider benign tonsillar ectopia as a potential risk factor for cerebellar injury following concussion.
- This case broadens the perspective on the relationship between cerebellar tonsil position and traumatic brain injury outcomes.
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