Controversies in the management of spontaneous cerebellar haemorrhage. A consecutive series of 49 cases and review of the literature

We have reviewed our experience with a series of 49 consecutive patients with spontaneous cerebellar haematoma, treated according to a standardized management protocol. Seventeen patients were managed conservatively, 30 underwent ventricular drainage, and in six patients the haematoma was evacuated....

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Bibliographic Details
Published in:Acta neurochirurgica 1993-01, Vol.122 (3-4), p.187-193
Main Authors: VAN LOON, J, VAN CALENBERGH, F, GOFFIN, J, PLETS, C
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Biological and medical sciences
Cerebellar Diseases - diagnosis
Cerebellar Diseases - etiology
Cerebellar Diseases - mortality
Cerebellar Diseases - surgery
Cerebral Hemorrhage - diagnosis
Cerebral Hemorrhage - etiology
Cerebral Hemorrhage - mortality
Cerebral Hemorrhage - surgery
Child
Craniotomy
Female
Follow-Up Studies
Glasgow Coma Scale
Humans
Hydrocephalus - diagnosis
Hydrocephalus - etiology
Hydrocephalus - mortality
Hydrocephalus - surgery
Magnetic Resonance Imaging
Male
Medical sciences
Middle Aged
Neurologic Examination
Neurology
Postoperative Complications - diagnosis
Postoperative Complications - etiology
Postoperative Complications - mortality
Postoperative Complications - surgery
Reoperation
Tomography, X-Ray Computed
Vascular diseases and vascular malformations of the nervous system
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Summary:We have reviewed our experience with a series of 49 consecutive patients with spontaneous cerebellar haematoma, treated according to a standardized management protocol. Seventeen patients were managed conservatively, 30 underwent ventricular drainage, and in six patients the haematoma was evacuated. The indications for the different modes of treatment are discussed. The most significant prognostic factors determining the outcome at one month were the grade of quadrigeminal cistern obliteration on the initial CT scan and the Glasgow Coma Scale on admission. Patients with normal cisterns had a good outcome, and only needed (temporary) ventricular drainage in case of hydrocephalus. Patients with totally obliterated cisterns had a bad outcome irrespective of treatment. In the patients with compressed cisterns, it is suggested that evacuation of the haematoma might improve outcome; treatment of hydrocephalus alone is insufficient in many cases in this group.
ISSN:0001-6268
0942-0940
DOI:10.1007/BF01405527