Hypoxic-ischaemic injury - the 'white cerebellum sign' versus the true 'reversal sign'

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2005

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South African Journal of Radiology

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University of Cape Town

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Abstract
A small percentage of patients who suffer a global cerebral hypoxic/ ischaemic injury develop reversal of the normal density relationship of grey and white matter on CT scans.1,2 The neuroradiology texts are confusing in their description of the CT appearance of the ‘reversal sign’3,4 which is a feature related to severe hypoxia (birth asphyxia, cardiopulmonary arrest), trauma (child abuse) and infection.1 2,5 We present two paediatric cases with this type of injury, one of which demonstrates the ‘white cerebellum sign’and the other the true ‘reversal sign’, in order to demonstrate the imaging differences
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