Traumatic midline cerebellar contusion in 2-year-old male child—case report and review of literature

Abstract

Background: Cerebellar contusion accounts for 0.54% of traumatic brain injuries. They present with a variety of symptoms like ataxia, dysmetria, dysdiadokinesia, and vertigo. CT scan is the gold standard investigation for diagnosing acute cerebellar contusions. Due to the low incidence of this disease, there are no medical guidelines available for the management of cerebellar contusions. Case report: A 2-year-old child presented to the emergency department with altered level of consciousness. Computed tomography scan of the brain showed midline cerebellar contusion. He was managed conservatively with the main focus on lowering intracranial pressure. Result: Cerebellar contusion can be managed conservatively with close monitoring. However, more data is needed to study its behaviour and management. Conclusions: The patient had an excellent response to treatment and was discharged within a few days further highlighting the role of medical management in the treatment of patients with cerebellar contusions.

Prognostic and morphological factors in pediatric cerebellar contusions

“…Typical signs of high ICP include headache, decreased arousal/altered sensorium, vomiting, and pupil irregularity. [ 8 , 15 ] There have been a few rare reported cases of cerebellar mutism in pediatric patients with cerebellar contusions. [ 3 , 10 ] This present study differed from the previously reported studies as 52.4% ( n = 11) of patients were unresponsive at admission, and another 23.8% ( n = 5) were somnolent but arousable to painful stimuli.…”

“…[ 2 ] Within the subsets of TBI, cerebellar contusions make up a small proportion of these injuries, as they are relatively uncommon. [ 8 , 19 ] Previously reported incidence rates of cerebellar contusions are <1% of head injuries, with some estimates as low as 0.4%. [ 17 , 18 ] Despite their relative rarity, cerebellar contusions are associated with substantial morbidity and mortality, with estimates of poor clinical outcomes ranging between 20% and 100%, with an average of 60%.…”

“…[ 17 , 18 ] Despite their relative rarity, cerebellar contusions are associated with substantial morbidity and mortality, with estimates of poor clinical outcomes ranging between 20% and 100%, with an average of 60%. [ 1 , 5 , 8 , 14 , 15 ] These injuries result in a myriad of long-term sequelae that have a significant impact on patients’ quality of life, including the resultant development of deficits in speech, attention, and fine motor movement. [ 15 ] Due to their relative rarity, the existing literature is limited on the factors predicting and influencing the clinical picture and long-term outcomes of patients sustaining cerebellar contusions.…”

“…The existing literature investigating cerebellar contusions in pediatric populations primarily consists of case reports/series and most studies focused on adult patients, with only a limited number of pediatric patient outcomes included. [ 8 , 14 ] However, there is a notable absence of morphologic studies investigating the 4 th ventricle and cisterna magna in the context of cerebellar contusions. As a result, there is a dearth of research examining prognostic and morphological factors contributing to the clinical picture and outcomes in cerebellar contusions, especially within pediatric populations.…”