Acute cerebellitis is an inflammatory syndrome occurring most commonly in young children. It is caused by a variety of insults and is usually bilateral. Pseudotumoral hemicerebellitis is an exceptionally rare unilateral presentation of acute cerebellitis mimicking a tumor. Magnetic resonance imaging (MRI) reveals a diffusely swollen cerebellar hemisphere, but with the lack of a well-defined mass, which is hyperintense in T2-weighted images and with pial enhancement in post-contrast images. It typically has a benign course with regression in follow-up scans, thus distinguishing it from a tumor. Recognizing this entity is important because erroneous diagnosis may lead to needless surgical intervention. We present a case of pseudotumoral hemicerebellitis in a 12-year-old boy with coagulopathy, with follow-up MRI depicting hemorrhage, and discuss the pathogenesis.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3401656PMC
http://dx.doi.org/10.4103/1817-1745.97625DOI Listing

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Pseudotumoral hemicerebellitis is a rare presentation of acute cerebellitis, which involves the inflammation of a single cerebellar hemisphere and most commonly affects children. It mimics a tumor on imaging, hence given the name. In this report, we present a case of pseudotumoral hemicerebellitis in a 30-year-old male who presented to the emergency room (ER) with complaints of vertigo, vomiting, and a headache.

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Article Synopsis
  • Pseudotumoral hemicerebellitis is an acute inflammation of the cerebellum primarily affecting children, and this study aims to assess the effectiveness of systemic corticosteroids in speeding up recovery.
  • A case report of a 12-year-old male with this condition is included, along with a review of 35 other cases focusing on recovery times.
  • Results indicate that patients treated with corticosteroids had a mean recovery time of 48.05 days, compared to 86.7 days for those who were not treated, suggesting that corticosteroids may significantly help in recovery.
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Pseudotumoral hemicerebellitis as a mimicker of Lhermitte-Duclos disease in children: does neuroimaging help to differentiate them?

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May 2016

Section of Pediatric Neuroradiology, Division of Pediatric Radiology, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.

The clinical presentation and neuroimaging findings of children with pseudotumoral hemicerebellitis (PTHC) and Lhermitte-Duclos disease (LDD) may be very similar. The differentiation between these entities, however, is important because their management and prognosis are different. We report on three children with PTHC.

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Acute cerebellitis is an inflammatory process that usually affects bilateral cerebellar hemispheres in the pediatric population. Pseudotumoral hemicerebellitis is an extremely rare presentation in which unilateral cerebellar involvement mimics a tumor that can exert significant mass effect on the surrounding structures, which may require surgical intervention. Magnetic resonance imaging characteristics that suggest cerebellitis include cerebellar swelling, T2 hyperintensity, and pial enhancement.

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