Neuropediatrics 2009; 40(5): 228-233
DOI: 10.1055/s-0030-1248265
Original Article

© Georg Thieme Verlag KG Stuttgart · New York

Cerebellar Cleft: Confirmation of the Neuroimaging Pattern

A. Poretti1 , T. A. G. M. Huisman2 , F. M. Cowan3 , E. Del Giudice4 , P. Y. Jeannet5 , D. Prayer6 , M. A. Rutherford3 , A. J.du Plessis7 , C. Limperopoulos7 , 8 , E. Boltshauser1
  • 1Department of Pediatric Neurology, University Children's Hospital of Zurich, Zurich, Switzerland
  • 2Division of Pediatric Radiology, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
  • 3Department of Paediatrics and Imaging Sciences Department, MRC Clinical Sciences Centre, Hammersmith Campus, Imperial College, London, UK
  • 4Section of Child Neuropsychiatry, Department of Pediatrics, University “Federico II”, Naples, Italy
  • 5Pediatric Neurology and Neurorehabilitation Unit, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
  • 6Department of Neuroradiology, Medical University of Vienna, Vienna, Austria
  • 7Fetal-Neonatal Neurology Research Program, Department of Neurology, Children's Hospital Boston and Harvard Medical School, Boston, MA, USA
  • 8Department of Neurology and Neurosurgery, School of Physical and Occupational Therapy, and Pediatrics, McGill University, Montreal, Quebec, Canada
Further Information

Publication History

received 26.11.2009

accepted 22.01.2010

Publication Date:
10 March 2010 (online)

Abstract

We recently described the neuroimaging and clinical findings in 6 children with cerebellar clefts and proposed that they result from disruptive changes following prenatal cerebellar hemorrhage. We now report an additional series of 9 patients analyzing the clinical and neuroimaging findings. The clefts were located in the left cerebellar hemisphere in 5 cases, in the right in 3, and bilaterally in one child who had bilateral cerebellar hemorrhages as a preterm infant at 30 weeks gestation. In one patient born at 24 weeks of gestation a unilateral cerebellar hemorrhage has been found at the age of 4 months. Other findings included disordered alignment of the folia and fissures, an irregular gray/white matter junction, and abnormal arborization of the white matter in all cases. Supratentorial abnormalities were found in 4 cases. All but 2 patients were born at term. We confirm the distinct neuroimaging pattern of cerebellar clefts. Considering the documented fetal cerebellar hemorrhage in our first series, we postulate that cerebellar clefts usually represent residual disruptive changes after a prenatal cerebellar hemorrhage. Exceptionally, as now documented in 2 patients, cerebellar clefts can be found after neonatal cerebellar hemorrhages in preterm infants. The short-term outcome in these children was variable.

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Correspondence

Andrea Poretti

Department of Pediatric Neurology

University Children's Hospital

Steinwiesstraße 75

8032 Zurich

Switzerland

Phone: +41/44/266 7330

Fax: +41/44/266 7163

Email: Andrea.Poretti@kispi.uzh.ch