Banana sign (cerebellum)

Changed by Rohit Sharma, 22 Oct 2022
Disclosures - updated 17 Aug 2022: Nothing to disclose

Updates to Article Attributes

Body was changed:

The banana sign is one of the many notable fruit inspired signs.

This sign is seen on axial imaging through the posterior fossa of fetuses with associated conditions such as  Chiari II malformation and/or spina bifida.

In Chiari II malformation, the banana sign describes the way the cerebellum is wrapped tightly around the brain stembrainstem as a result of spinal cord tethering and downward migration of the posterior fossa contents. This results in obliteration of the cisterna magna and subsequently, the shape of the cerebellum has the appearance of a banana. The sign persists into the second and third trimesters.

The banana sign is also seen in the majority of fetuses with spina bifida. The ultrasound appearance of the banana sign is secondary to the abnormality of the cerebellar shape3.  In patients with spina bifida, this appearance disappears after 24 weeks. There is frequently concurrent hydrocephalus.

Associated signs

The same condition also gives rise to the lemon sign.

  • -<p>The <strong>banana sign</strong> is one of the many notable <a href="/articles/fruit-inspired-signs-1">fruit inspired signs</a>.</p><p>This sign is seen on axial imaging through the posterior fossa of fetuses with associated conditions such as  <a href="/articles/chiari-ii-malformation">Chiari II malformation</a> and/or <a href="/articles/spina-bifida">spina bifida</a>.</p><p>In <a href="/articles/chiari-ii-malformation">Chiari II malformation</a>, the banana sign describes the way the cerebellum is wrapped tightly around the brain stem as a result of <a href="/articles/spinal-cord-tethering">spinal cord tethering</a> and downward migration of the posterior fossa contents. This results in obliteration of the cisterna magna and subsequently, the shape of the cerebellum has the appearance of a banana. The sign persists into the second and third trimesters.</p><p>The banana sign is also seen in the majority of fetuses with <a href="/articles/spina-bifida">spina bifida</a>. The ultrasound appearance of the banana sign is secondary to the abnormality of the cerebellar shape<sup>3</sup>.  In patients with spina bifida, this appearance disappears after 24 weeks. There is frequently concurrent <a href="/articles/hydrocephalus">hydrocephalus</a>.</p><h5>Associated signs</h5><p>The same condition also gives rise to the <a href="/articles/lemon-sign-1">lemon sign</a>.</p>
  • +<p>The <strong>banana sign</strong> is one of the many notable <a href="/articles/fruit-inspired-signs-1">fruit inspired signs</a>.</p><p>This sign is seen on axial imaging through the posterior fossa of fetuses with associated conditions such as  <a href="/articles/chiari-ii-malformation">Chiari II malformation</a> and/or <a href="/articles/spina-bifida">spina bifida</a>.</p><p>In <a href="/articles/chiari-ii-malformation">Chiari II malformation</a>, the banana sign describes the way the cerebellum is wrapped tightly around the brainstem as a result of <a href="/articles/spinal-cord-tethering">spinal cord tethering</a> and downward migration of the posterior fossa contents. This results in obliteration of the cisterna magna and subsequently, the shape of the cerebellum has the appearance of a banana. The sign persists into the second and third trimesters.</p><p>The banana sign is also seen in the majority of fetuses with <a href="/articles/spina-bifida">spina bifida</a>. The ultrasound appearance of the banana sign is secondary to the abnormality of the cerebellar shape<sup>3</sup>.  In patients with spina bifida, this appearance disappears after 24 weeks. There is frequently concurrent <a href="/articles/hydrocephalus">hydrocephalus</a>.</p><h5>Associated signs</h5><p>The same condition also gives rise to the <a href="/articles/lemon-sign-1">lemon sign</a>.</p>

References changed:

  • 3. Benacerraf BR, Stryker J, Frigoletto FD. Abnormal US appearance of the cerebellum (banana sign): indirect sign of spina bifida. (1989) Radiology. 171 (1): 151-3. <a href="https://doi.org/10.1148/radiology.171.1.2648467">doi:10.1148/radiology.171.1.2648467</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/2648467">Pubmed</a> <span class="ref_v4"></span>
  • B R Benacerraf, J Stryker, F D Frigoletto, Jr. Abnormal US appearance of the cerebellum (banana sign): indirect sign of spina bifida. (1989) Radiology. 171 (1): 151-3. <a href="https://doi.org/10.1148/radiology.171.1.2648467">doi:10.1148/radiology.171.1.2648467</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/2648467">Pubmed</a> <span class="ref_v4"></span>

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