Acute pseudotumoral hemicerebellitis: Diagnosis and neurosurgical considerations of a rare entity

Cohen, José E.; Gomori, Moshe; Benifla, Moni; Itshayek, Eyal; Shoshan, Yigal

doi:10.1016/j.jocn.2013.04.006

Cited by 7 publications

(9 citation statements)

References 20 publications

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“…Up to now, 22 cases of hemicerebellitis have been reported, of which only 9 were with pseudotumoral onset and without any cerebellar signs. [1][2][3][4][5][6][7][8][9] In all these 9 cases, as in our patient, the clinical symptomatology was characterized by progressive signs of intracranial hypertension, such as headache, vomiting, and neck stiffness, and none of them had cerebellar signs, namely, ataxia or dysarthria.…”

Section: Discussionsupporting

confidence: 57%

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Acute Pseudotumoral Hemicerebellitis in a Child

et al. 2014

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A pseudotumoral presentation of acute hemicerebellitis is rare in pediatric age. The authors report a new single case study of a 7-year-old child with pseudotumoral unilateral cerebellitis mimicking an intracranial tumor, which clinically presented itself with signs of intracranial hypertension and mild contralateral hemiparesis, completely recovered after anti-inflammatory therapy. Brain magnetic resonance imaging (MRI) was essential for the differential diagnosis between inflammatory and neoplastic processes. The literature highlighting specific clues about pseudotumoral hemicerebellitis as a distinct clinical and radiological entity is reviewed.

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Section: Discussionsupporting

confidence: 57%

“…[1][2][3][4][5][6][7][8][9] In all these 9 cases, as in our patient, the clinical symptomatology was characterized by progressive signs of intracranial hypertension, such as headache, vomiting, and neck stiffness, and none of them had cerebellar signs, namely, ataxia or dysarthria.…”

Section: Discussionmentioning

confidence: 77%

Acute Pseudotumoral Hemicerebellitis in a Child

et al. 2014

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“…Imaging patterns vary widely (Figures 1 to 6, Table 3). In only 3 of our patients did we find the most frequently reported imaging picture of bilateral symmetric hyperintensity on T2-weighted and fluid-attenuated inversion recovery images (Figures 3 and 5A, Table 3), whereas 4 had unilateral involvement, reported less often, 21,22 including 2 with an additional focus in the vermis or in the other hemisphere. One patient demonstrated isolated involvement of the vermis (patient no.…”

Section: Discussionmentioning

confidence: 70%

“…Long-term studies report that a residual hyperintense signal persists on T2-weighted MRI, even after symptoms lessen, as does the cerebellar atrophy, to various degrees (Figure 1C). 8,21 The hyperintensity reflects gliosis and enlargement of the cerebellar folia.…”

Section: Discussionmentioning

confidence: 99%

Acute Cerebellitis in Children

et al. 2016

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Acute cerebellitis is a rare inflammatory condition. It may have a benign, self-limiting course or present as a fulminant disease resulting in severe cerebellar damage or even sudden death. We present the clinical, laboratory, and radiologic data in 9 children diagnosed with acute cerebellitis, who were identified by database search in our pediatric medical center from January 2000 to November 2014. The main presenting symptom was headache, and the main presenting sign was ataxia. Bilateral diffuse hemispheric involvement was the most common imaging finding at presentation. Mycoplasma pneumoniae was the most common infectious pathogen found. Treatment included steroids in all cases, antibiotics in 4, and intravenous immunoglobulins in 6. Six patients had a full recovery, and 3 had residual neurologic complications. Magnetic resonance imaging (MRI) is the modality of choice for diagnosis. The course of acute cerebellitis varies from a commonly benign and self-limiting disease to an occasionally fulminant disease, resulting in severe cerebellar damage or sudden death.

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“…Edema of the posterior fossa may require posterior fossa decompression with external ventricular drainage. Ventriculostomy is performed in some cases (Cohen et al 2014). Glycerol and dexamethasone may be beneficial in case of a swollen vermis (de Ribaupierre et al 2005).…”

Section: Treatmentmentioning

confidence: 99%