We present two recent cases of toddlers who developed malignant cerebellar edema
subsequent to accidental ingestion of prescription opioids. Both children presented acute
neurological decline, hydrocephalus, and tonsillar herniation requiring emergent ventricular
drain placement, suboccipital craniectomy, and partial cerebellectomy. Together with
several other reports, these cases suggest the existence of an uncommon yet severe
syndrome of acute opioid-induced malignant cerebellar edema. We hypothesize that the …