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Complicated acute cerebellitis with obstructive hydrocephalus and tonsillar herniation in a child
Manchikanti Venkatesh1, Sunitha Vellathussery Chakkalakkoombil1, Manju Bashini Duraipandi1
1Radiodiagnosis, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India.
Insights
Acute cerebellitis (AC) is a rare, potentially fatal inflammatory brain condition. Prompt diagnosis and management, including shunting for hydrocephalus, are crucial for recovery in children.
Area of Science:
- Neurology
- Pediatrics
- Radiology
Background:
- Acute cerebellitis (AC) is a rare inflammatory syndrome primarily affecting children, characterized by cerebellar dysfunction.
- AC can lead to severe complications like obstructive hydrocephalus and brainstem compression, necessitating urgent intervention.
Observation:
- A 12-year-old boy presented with ataxia and signs of raised intracranial pressure.
- CT and MRI scans revealed acute cerebellitis with obstructive hydrocephalus and tonsillar herniation.
Findings:
- The patient was treated with medication for elevated intracranial pressure and a ventriculoperitoneal shunt.
- Complete recovery occurred within two weeks of management.
Implications:
- Diagnostic imaging (CT/MRI) is vital for identifying AC and distinguishing it from acute cerebellar ataxia.
- Early diagnosis and management of AC and its life-threatening complications are critical for favorable outcomes.
Abstract:
Acute cerebellitis (AC) is a rare inflammatory syndrome presenting as cerebellar dysfunction, seen more frequently in children. AC can have a variable course with features of cerebellar dysfunction, raised intracranial pressure and neurological deficits, and can sometimes even be potentially fatal due to complications such as obstructive hydrocephalus and brainstem compression, warranting surgical intervention. We report a case of a 12-year-old boy who presented with raised intracranial pressure and ataxia. Imaging with CT and MRI showed AC with obstructive hydrocephalus and tonsillar herniation. He was managed with medications for raised intracranial pressure and with ventriculoperitoneal shunt, and he recovered completely over a period of 2 weeks. Imaging has an important role in the diagnosis of AC and in differentiating it from acute cerebellar ataxia, which has a more benign course. It is crucial to diagnose and promptly manage the rarely occurring but life-threatening complications of AC.
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