Contusions are defined as any injury to the body occurring following trauma that leads to blood vessel rupture and tissue destruction. Following contusions, the area is marked by active bleeding into the tissue . This traumatic brain injury (TBI) is a major cause of morbidity and mortality worldwide and affects up to 10 million individuals annually .
Tsai et al. state that only 3.3% of traumatic brain injuries involve the posterior fossa. These injuries include extra-dural hematomas, sub-dural hematomas, and rarely cerebellar contusions (which account for less than 1% of all head injuries) .
D’Avella et al. state that cerebellar contusions make up only 0.54% of all head injuries. He categorized the type of injuries causing cerebellar contusions into coup injuries (where the occiput is the area of impact), countercoup injuries (where the frontal or temporal area is targeted), and acceleration-deceleration injuries .
Cerebellar contusions present in a variety of ways. In adults, they will present with cerebellar signs like nystagmus, dysarthria, hypotonia, ataxia, dysmetria, tremor, dysdiadochokinesis, and vertigo . In children, additional signs like cerebellar mutism have also been seen. One study by Braga et al. studied the neuropsychological sequelae in children with cerebellar trauma, according to the study, most children with cerebellar trauma develop dyscalculia and exhibit lower visual recognition memory .
Computed tomography scan is the gold standard investigation for evaluating cerebellar contusions. It shows the size of the contusion, its location, the status of fourth ventricles and cisterns, and any associated lesion like extra-dural or sub-dural hematomas.
Due to the rarity of traumatic intra cerebellar contusions, only case reports and case series are published detailing the presentation and the management of this disease with the management itself remaining quite controversial. Here, we present a case report of a male child with midline intra cerebellar contusion and his subsequent medical therapy. The management of our respective patient can help the greater scientific community in better understanding of the requisite treatment for this unique phenomenon.