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A Novel Radiological Score System to Assess the Clinical Severity in Patients with Acute Cerebellitis

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Abstract

To develop a radiological score system to assess the severity of acute cerebellitis (AC) and to compare radiological severity score at the onset to cerebellar atrophy at follow-up. Clinical and MRI findings were recorded in 16 patients with AC. Radiological severity score considering topographic patterns, gray/white matter involvement, enhancement, tonsillar herniation or hydrocephalus development and clinical severity score taking into account clinical symptoms were assessed for each patient at the onset of the symptoms. Radiological and neurological sequelae were assessed at follow-up. At symptoms onset, clinical severity scale ranged from mild to severe and radiological severity score ranged from 3 to 7 with higher scores indicating a greater severity. The cut-off value of 5 for radiological score well segregated severe patients defined by clinical scale. A significant correlation between clinical scale and radiological severity scores (p < 0.001, r = 0.75) was found. At follow-up visit, all children developed cerebellar atrophy and 5 children showed neurologic sequelae while adults showed complete resolution without atrophy. Patients in whom atrophy was not observed had both older ages (p < 0.001) and a focal cerebellar involvement (p = 0.03). In patients with AC, radiological severity score may be a useful tool in evaluating clinical severity, but it is not capable to predict neither neurological sequelae nor evolution towards atrophy. Cerebellar atrophy, observed in children with AC, may be caused by several factors such as the age of patient and the extension of cerebellar involvement and it may be counterbalanced by neuronal restoring processes due to neuroplasticity.

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Authors and Affiliations

  1. Fondazione Policlinico Universitario Agostino Gemelli IRCCS, UOC Radiologia e Neuroradiologia, Polo Diagnostica per Immagini, Radioterapia, Oncologia ed Ematologia, Area Diagnostica per Immagini, Rome, Italy

    Rosalinda Calandrelli, Panfili Marco & Cesare Colosimo

  2. Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Rome, Italy

    Huong Elena Tran

  3. Università Cattolica del Sacro Cuore, Istituto di Radiologia, Rome, Italy

    Cesare Colosimo

  4. Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Campus Bio-Medico University, 00128, Rome, Italy

    Fabio Pilato

Authors
  1. Rosalinda Calandrelli
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  2. Panfili Marco
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  3. Huong Elena Tran
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  4. Cesare Colosimo
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  5. Fabio Pilato
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Correspondence to Fabio Pilato.

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Ethics Approval

We declare that all procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

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Informed consent was obtained from all individual participants included in the study.

Conflict of Interest

Rosalinda Calandrelli declares that she has no conflict of interest. Marco Panfili declares that he has no conflict of interest. Huong Elena Tran declares that she has no conflict of interest. Cesare Colosimo declares that he is a scientific consultant for Bracco Diagnostics Inc. and Bayer HealthCare. Fabio Pilato declares that he has no conflict of interest.

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Calandrelli, R., Marco, P., Tran, H.E. et al. A Novel Radiological Score System to Assess the Clinical Severity in Patients with Acute Cerebellitis. Cerebellum 22, 173–182 (2023). https://doi.org/10.1007/s12311-022-01377-5

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  • DOI: https://doi.org/10.1007/s12311-022-01377-5

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