Medical and surgical treatment of intracerebellar haematomas

15 cases of intracerebellar haematomas [11 spontaneous, 2 traumatic and 2 unclear] were presented. Hypertension was thought to be a main risk factor in 91% in 11 of the spontaneous cases. 11 cases were treated medically. They were usually conscious, scoring not less than 13 in GCS with subacute or c...

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Bibliographic Details
Published in:Acta neurochirurgica 1991, Vol.110 (1-2), p.24
Main Authors: Koziarski, A, Frankiewicz, E
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Carotid Arteries - diagnostic imaging
Cerebellar Diseases - diagnostic imaging
Cerebellar Diseases - etiology
Cerebellar Diseases - mortality
Cerebellar Diseases - therapy
Cerebral Hemorrhage - diagnostic imaging
Female
Follow-Up Studies
Hematoma - diagnostic imaging
Hematoma - etiology
Hematoma - mortality
Hematoma - therapy
Humans
Hydrocephalus - etiology
Hypertension - complications
Male
Middle Aged
Postoperative Complications - mortality
Risk Factors
Survival Rate
Tomography, X-Ray Computed
Vertebral Artery - diagnostic imaging
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Summary:15 cases of intracerebellar haematomas [11 spontaneous, 2 traumatic and 2 unclear] were presented. Hypertension was thought to be a main risk factor in 91% in 11 of the spontaneous cases. 11 cases were treated medically. They were usually conscious, scoring not less than 13 in GCS with subacute or chronic picture of illness and harbouring small haematomas below 3 cm in diameter situated almost always in the hemisphere and with no signs of ventricular dilation. Mortality in medically treated patients was 9% [1 case]. The remainder were discharged in good state, usually with no or only slight neurological deficit. Complete haematoma absorption took about 14 days. There were no signs of delayed hydrocephalus in subsequent CT scans. When the haematoma was large, more than 3 cm in diameter, located usually in the vermis or in the vermis and cerebellar hemisphere, sometimes with ventricular involvement, the clinical presentation was acute and required CT diagnosis and surgical evacuation without delay due to low and deteriorating conscious level. Postoperative mortality was 25%, but delayed mortality was 100%. Vertebral angiography was performed in all cases of spontaneous haemorrhage and was normal in 54%, revealed atheromatous changes in 36% and the signs of cerebellar haematoma in only 10%. Arteriovenous malformations were excluded from this study. The authors believe, that the benign course of intracerebellar haematomas is more frequent than it was considered previously and needs no surgical treatment in many cases.
ISSN:0001-6268