title: Acute hemicerebellitis in a young adult: a case report and literature review.
abstract: Acute hemicerebellitis, marked by headache with or without cerebellar signs, is a rare clinical entity involving a unilateral cerebellar hemisphere. The pathogenesis of acute hemicerebellitis remains unclear, and the disease rarely occurs in adults. Here, we report an 18-year-old woman who presented with a lack of coordination of the right hand and leg lasting longer than one week, following a pulsatile headache. A neurological examination disclosed ocular dysmetria, right-sided limb ataxia and slight truncal ataxia. Cerebrospinal fluid analysis showed mononuclear pleocytosis. The serology and autoimmune studies were unremarkable. Brain magnetic resonance imaging (MRI) revealed a focal signal change in the right cerebellar hemisphere and vermis. Acute hemicerebellitis was diagnosed, and the patient was treated with intravenous methylprednisolone sodium succinate and acyclovir. Subsequently, the headache resolved, and the cerebellar signs were markedly improved. Twenty days after admission, she became asymptomatic and brain MRI showed resolution of cerebellar hyperintensity on the right side. In conclusion, we identified only 6 additional patients with adult-onset acute hemicerebellitis from previous reports, highlighting the importance of recognizing this rare clinical entity. Its clinical outcome is usually favorable, but in the acute phase, attention should be directed toward clinical symptoms that are suggestive of increased intracranial pressure.
authors.affiliation: Department of Neurology, Dokkyo Medical University, Tochigi, Japan. Electronic address: keisuke@dokkyomed.ac.jp.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Suzuki
authors.affiliation: Department of Neurology, Rehabilitation Amakusa Hospital, Saitama, Japan.
authors.forename: Toshiki
authors.initials: T
authors.lastname: Nakamura
authors.affiliation: Department of Neurology, Dokkyo Medical University, Tochigi, Japan.
authors.forename: Ayaka
authors.initials: A
authors.lastname: Numao
authors.affiliation: Department of Neurology, Dokkyo Medical University, Tochigi, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Fujita
authors.affiliation: Department of Neurology, Dokkyo Medical University, Tochigi, Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Komagamine
authors.affiliation: Department of Neurology, Dokkyo Medical University, Tochigi, Japan.
authors.forename: Takahide
authors.initials: T
authors.lastname: Nagashima
authors.affiliation: Department of Neurology, Dokkyo Medical University, Tochigi, Japan.
authors.forename: Yohei
authors.initials: Y
authors.lastname: Asakawa
authors.affiliation: Department of Neurology, Dokkyo Medical University, Tochigi, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Watanabe
authors.affiliation: Department of Neurology, Dokkyo Medical University, Tochigi, Japan.
authors.forename: Hidehiro
authors.initials: H
authors.lastname: Takekawa
authors.affiliation: Department of Neurology, Dokkyo Medical University, Tochigi, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Hirata
mesh_terms: D000208:Acute Disease; D000212:Acyclovir / Q000627:therapeutic use*; D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000998:Antiviral Agents / Q000627:therapeutic use; D002526:Cerebellar Diseases / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D018792:Encephalitis, Viral / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006261:Headache / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D019586:Intracranial Hypertension / Q000150:complications / Q000209:etiology; D008279:Magnetic Resonance Imaging; D008776:Methylprednisolone Hemisuccinate / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D005938:Glucocorticoids; D008776:Methylprednisolone Hemisuccinate; D000212:Acyclovir
keywords: Acute hemicerebellitis; Headache; Magnetic resonance imaging; Steroid; Surgical decompression; Young adult