Faiza Naz, Sadaf Irshad Khan, Imaad-ur Rehman.
Dark cerebellar sign: a case report.
Pak J Radiol Jan ;28(3):240-2.

We are here to discuss a case of `dark cerebellar sign`, a rare sign in neuroradiology. Dark cerebellar sign is characterized by a hypoxic ischemic insult resulting in an edematous cerebellum that appears hypodense on CT scan. Our patient is a 13 year old male, known case of Acute lymphocytic leukemia (ALL) for 7 years, treated for relapse, recurrent febrile illnesses and discharged from hospital two days before presenting in ER in a collapsed state with metabolic derangements and dark cerebellar sign on CT scan. Etiology of this sign is not well established as isolated infarction of cerebellum is rare. A single case report has shown an association of TCA (tricyclic antidepressants) intoxication with dark cerebellar sign. Our case shows that metabolic derangements, hematological diseases and infections should be included in the list of differential diagnosis for isolated cerebellar infarction in children.

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