Objectives: We aimed to discuss the effectiveness of decompressive surgery due to fulminant acute cerebellitis in the posterior fossa. Methods: The data of a case diagnosed with fulminant acute cerebellitis will be discussed. Results: A 4-year-old previously healthy boy presented with vomiting, diarrhea and altered mental status for the last 2 days. He was confused and his Glascow coma scale was 11 with stable vital signs. The rest of the physical examination was normal. Brain MRI showed widespread hyperintensity of both cerebellar hemisphers and splenium of corpus callosum, and prominent cerebellar swelling. CSF analysis revealed normal protein and glucose levels with mild pleocytosis. CSF PCR analysis was negative for common causes of viral meningoencephalitis. Serum anti-MOG was negative. Hypertonic saline was used to reduce posterior fossa edema. Control brain MRI showed hydrocephalus and increased cerebellar edema. Extraventricular drainage was installed, but clinical findings gradually worsened. Apnea and bradycardia developed, brainstem reflexes weakened, and then the patient was intubated. Brain CT showed cerebellar herniation and brainstem compression. Craniectomy and partial cerebellar resection were done urgently. The case improved rapidly in the postoperative period. During the long-term follow-up, neurologic status of the case was normal for his age. Conclusion: In this case diagnosed as acute cerebellitis with a fulminant course, the life-threatening volume and pressure increase in the posterior fossa could be controlled by resection of the cerebellar vermis with a favourable neurologic prognosis. Therefore, we emphasize that decompressive surgery may be life-saving in selected cases of cerebellitis with a fulminant course.

Defne Alikılıç
Kocaeli University
Turkey

Gökçe Çırdı
Kocaeli University
Turkey

Adnan Deniz
Kocaeli University
Turkey

Ayfer Güneş
Kocaeli University
Turkey

Bülent Kara
Kocaeli University
Turkey