Introduction: The cerebellum contributes to attention, language and visuo spatial function.

Aim of the study:  we aimed to evaluate degree of cerebellar involvement in magnetic resonance imaging (MRI) of patients with neonatal hypoxic ischemic encephalopathy (HIE) ,to assess the relevance of cerebellar vermis atrophy to  severity of the disease and its relation to patients’ cognitive function tests .

Methods: Thirty children with HIE were enrolled. They were investigated by MRI, VEP and cognitive functions assessment.

Results: Abnormalities in MR images were mainly confined to  posterior putamen, ventrolateral thalamus and paracentral white matter. According to total scores of changes in these areas, patients were grouped into group I of 20 patients (66.7%) having scores of 5 of 9 or less and group II of 10 patients (33.3%) having scores of 6 of 9 or more. Seven patients (23.3%) had high T2 signal intensity in the cerebellar vermis and high signal lesions in ffected sites. The presence of vermian involvement was significantly associated with MR evidence of severe hypoxic damage in ypically affected sites (p=0.038). Cognitive function tests were significantly impaired in patients of group II and in patients with cerebellarermian atrophy compared to patients of group I and patients without vermian atrophy, respectively (p‹0.05). Abnormal VEP were more frequent in patients of group II compared to group I.

Conclusion: Our results may suggest  that vermian atrophy in MR images of patients with HIE can predict cognitive impairment and thus may be  suggesting early intervention for learning disabilities.