dense cerebellum sign

White cerebellum sign, also called reversal sign or dense cerebellum sign, is encountered when there is a diffuse decrease in density of the supratentorial brain parenchyma, with relatively increased attenuation of the thalami, brainstem and cerebellum. This sign indicates irreversible brain damage and has a very poor prognosis, which is why radiologists must be aware of this sign .


It is associated with:


There are different theories proposed for this sign:

  • raised intracranial pressure causes partial venous obstruction resulting in distension of deep medullary veins
  • preferential flow to posterior circulation
  • transtentorial herniation partially relieving the increased intracranial pressure and thus increase perfusion of central structures
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