WHITE CEREBELLUM SIGN

7 years old boyPresented in emergency with H/o Head injury due to fall from height with profuse bleeding from lacerated wound in scalp. GCS E1VTM1. Bilateral pupils dilated and not reacting to light. Doll's eye reflex.NEUROSURGEON explained poor prognosis to relatives What should be done? 1. In view of his young age, should go for aggressive craniotomy? 2. Or just explain the prognosis?

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This is a case of severe head injury with white cerebellum sign with severe cerebral hypoxia,and diffuse neuronal injury The “white cerebellum” sign is a rare imaging finding described mainly in children with hypoxic brain injury..This indicates a very poor prognosis I don't- think craniotomy will improve the prognosis

Valuable opinion
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Severe head injury Diffuse hemorrhage all most all over cranium Rt extracranial hematoma seen Pt is critical with GCS 3 only Pupils are dialated and fixed not reacting to light very very poor prognosis rather fatal I will not suggest craniotomy at this point of time

Thanx dr Mansukh Shah
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Congratulations! Your case has been selected as Case of the day and you have been awarded 5 points for sharing the case. Keep posting your interesting cases, Happy Curofying!

Thank you doctor
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Supportive care. Just explain the prognosis and documents everything's in the medical record .Do an apnea test and inform the relatives.

Valuable opinion
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Subdural haematoma in occipital region Unconscious Intubate Mri spine Dns drip Opinion of neurosurgeon Aggressive craniotomy

Acute bleed in occipital region
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Explain outcome How long delay was there from onset to presentation ? Although white cerebellar sign itself showing very obvious there must be significant delay If all other brainstem sign was negative, no need for any surgery

Bad prognosis explain the relatives.no role for decompessive craniectomy

Valuable opinion
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patient is beyond help..assess for brain death and declare

Guarded prognosis

methylmalonic acidemia,vitamin B12 metabolism with a poor prognosis that can cause brain damage.

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