Cerebellar atrophy after severe traumatic head injury in children

Objects: The purpose of this study was to describe late neuropathological M RI findings in pediatric severe head injury and to explore the relationship between these lesions and cognitive sequelae. Methods: Thirteen infants wi th severe head trauma (Glasgow 6) were included in this investigation. Clin ical examination, a battery of tests designed to assess neurophysiological status, and MRI investigations of the brain were obtained in periods rangin g between 8 and 20 months after the accident. Hemosiderin deposits, encepha lomalacia, and cerebellar atrophy were the most frequent traumatic sequelae . The lesions were located in frontal lobes, the basal ganglia, and the cer ebellum. Six patients had cerebellar atrophy associated with frontal or tem poral postraumatic lesions. Cerebellar clinical dysfunction was observed in only 3 of these patients. Performance on tests evaluating frontal lobe fun ctions was depressed in 5 of them. Conclusions: Late MRI after severe head trauma in our pediatric population showed unexpected cerebellar atrophy. It s correlation with prefrontal dysfunction is difficult to confirm because o f its association with other parenchymal post-traumatic lesions. Further re search involving a larger sample of patients with brain injury of varying s everity is in progress, to investigate whether cerebellar atrophy could be a consequence of severe head trauma.