Alvarez-Betancourt L, Ramírez-Mendoza A, López-Ortega SJ, Caldera-Duarte A

Language: Spanish
References: 11
Page: 191-194
PDF size: 56.80 Kb.

ABSTRACT

Objective: Describe eighteen patients with spontaneous cerebellar haematoma (SCH), their diagnosis, management and outcome.
Patients and Method: 18 patients were seen at the Hospital de Especialidades CMN "La Raza" between January 2001 and July 2003. Patients were male and female over 16 years that showed signs compatible with SCH. Fourth ventricle compression, neurological status, hydrocephalus, concomitant diseases, management and postoperative status were assessed. Fourth ventricle compression was divided in three stages. Management included: 1) conservative approach, 2) craniectomy and haematoma drainage, 3) craniectomy haematoma drainage and ventricular derivation, 4) ventriculostomy and 5) absence of treatment.
Results: SCH was observed for over six hours in 11 patients (62%). Systemic hypertension was present in 13 patients (72%), hydrocephalus in 12 (66%), five patients displayed a favourable outcome and were able to lead independent lives (28%), three patients (17%) had a guarded outcome, dependent on others for daily living skills and 10 patients died.
Conclusions: SCH is a medical and surgical emergency. Neurological status and degree of fourth ventricle compression are the most important factors on which to base clinical management and infer prognosis.

REFERENCES

1. González J, Gelabert M, García A, Fernández J, López E. Cerebellar hematomas: a surgically treatable stroke. Rev. Neurol. 2000:31(12);119-126.

2. Salvati M, Cervoni L, Raco A, Delfini R. Spontaneous cerebellar hemorrhage: clinical remarks on 50 cases. Surg Neurol. 2001:55(3);156-161.

3. Bayassi S, Kopczynski S, Derenda M, Siwiecki T. Spontaneous cerebellar haematomas. Results of surgical treatment. Neurol Neurochir Pol. 2002:36(5);911-924.

4. Van Loon J, Van Calenbergh F, Goffin J, Plets C. Controversies in the management of spontaneous cerebellar haemorrhage. A consecutive series of 49 cases and review of the literature. Acta Neurochir (Wien). 1993:122(3-4);187-193.

5. Chin D, Carney P. Acute cerebellar hemorrhage with brainstem compression in contrast with benign cerebellar hemorrhage. Surg Neurol. 1983:19(5);406-409.

6. Kobayashi S, Sato A, Kageyama Y, Nakamura H, Watanabe Y, Yamura A. Treatment of hypertensive cerebellar hemorrhage. Surgical or conservative management. Neurosurgery. 1994:34;246-251.

7. Hodelin-Tablada R. Spontaneous intracranial hematomas. A surgical solution? Rev. Neurol. 1997:25(148);1998-2002.

8. Koziarski A, Frankiewicz E. Medical and surgical treatment of intracerebellar haematomas. Acta Neurochir (Wien). 1991:110(1-2);24-28.

9. Brennan RW, Bergland RM. Acute cerebellar hemorrhage. Analysis of clinical findings and outcome in 12 cases. Neurology. 1977:27(6);527-532.

10. Lui TN, Fairholm DJ, Shu TF, Chang CN, Lee ST, Chen HR. Surgical treatment of spontaneous cerebellar hemorrhage. Surg Neurol. 1985:23(6);555-558.

11. Karnofsky D, Burchenal J. In evaluation of chemotherapy agents. MacLeod C.M. (ed.). Columbia University Press: New York 1949, pp 191-205.