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

• 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
• ISSN: 0001-6268; 0942-0940
• DOI: 10.1007/BF01405527

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.