Summary
We have studied 15 cases of spontaneous intracerebellar haematomas in 9 males and 6 females. A significant correlation between the clinical presentation and the CT scan features of benign and fatal haemorrhages of the cerebellum is presented.
Diagnostic computerized tomographic studies were performed in a mean interval of 31 hours after the initial symptoms. 60% were diagnosed and treated in less than 24 hours; 11 patients had haematomas larger than 3 cm, and 5 (45%) of these cases died with evidence of irreversible brain-stem damage. Twelve (80%) showed compression of the fourth ventricle, 9 (60%) obliteration of the brainstem cisterns and 8 (53%) ventricular dilatation.
8 cases were treated with surgery; 50% of them showed neurological improvement, including two cases with signs of brain-stem compression. 7 patients who were treated conservatively were followed closely with repeated CT scans, which showed that resolution of the mass effect and isodensity of the haematomas occurred within 9 to 15 days, with a mean of 11 days, after the initial CT scan. An increased mortality was observed with haematomas larger than 3cm (73%), hydrocephalus (45%) and intraventricular haemorrhage (40%). Smaller haematomas without CT scan evidence of obliteration of the brain-stem cisterns or hydrocephalus had a better outcome.
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References
Ballance, H., A case of traumatic hemorrhage into the left lateral lobe of the cerebellum, treated by operation with recovery. Surg. Gynec. Obstet.3 (1906), 223–225.
Bogouslavsky, J., Regli, F., Jeanranaud, X., Benign outcome in unoperated large cerebellar haemorrhage, Report of two cases, Acta Neurochir. (Wien)73 (1984), 59–65.
Brillman, J., Acute hydrocephalus and death one month after nonsurgical treatment for acute cerebellar hemorrhage. J. Neurosurg.50 (1979), 374–376.
Cioffi, F. A., Bernini, F. P., Punzo, A., d'Avanzo, R., Surgical management of acute cerebellar infarction. Acta Neurochir. (Wien)74 (1985), 105–112.
Dolinskas, C. A., Bilaniuk, L. T., Zimmerman, R. A., Kuhl, D. E., Computed tomography of intracerebral hematomas. I. Transmission CT observations on hematoma resolution. Amer. J. Roentgenol.129 (1977 a), 681–688.
Fisher, C. M.,et al., Acute hypertensive cerebellar hemorrhage: Diagnosis and surgical treatment. J. Nerv. Ment. Dis.140 (1965), 38–57.
Freeman, R. E., Onofrio, B. M., Okazaki, H.,et al., Spontaneous intracerebellar hemorrhage. Diagnosis and surgical treatment. Neurology23 (1973), 84–90.
Heiman, T. D., Satya-Murti, S., Benign cerebellar hemorrhages. Ann. Neurol.3 (1978), 366–368.
Little, J. R., Tubrian, E. D., Ethier, R., Cerebellar hemorrhage in adults. J. Neurosurg.48 (1978), 575–579.
McKissock, W., Richardson, A., Walsh, L., Spontaneous cerebellar hemorrhages. Brain83 (1960), 1–9.
Messina, A. V., Chernik, N. L., Computed tomography: the resolving intracerebral hemorrhage. Radiology118 (1975), 609–613.
Mitchell, N., Angrist, A., Spontaneous cerebellar hemorrhage: Report of 15 cases. Amer. J. Pathol.18 (1942), 235–253.
Norris, J. W., Eisen, A. A., Branch, C. L., Problems in cerebellar hemorrhage and infarction. Neurology19 (1969), 1043–1050.
Ott, K. H., Kase, C. S., Ojeman, R. G.,et al., Cerebellar hemorrhage: diagnosis and treatment. A review of 56 cases. Arch. Neurol.31 (1974), 160–167.
Pozzati, E., Piazza, G. C., Padovani, R.,et al., Benign traumatic intracerebellar hematomas. Neurosurgery3 (1981), 102–103.
Pressman, B. P., Kirkwood, J. R., Davis, D. O., Posterior fossa hemorrhage. Localization by computerized tomography. J.A.M.A.232 (1975), 932–935.
Sedillot, J., Epanchément de sang dans le lobe droit du cervelet, suivi de la mort. J. Gen. Med. Chir. Pharm.47 (1813), 375–379.
Seelig, J. M.,et al., Ventriculostomy for hydrocephalus in cerebellar hemorrhage. Neurology31 (1981), 1537–1540.
Theodore, W. H., Striar, J., Burger, A., Nonsurgical treatment of cerebellar hematoma. Mt. Sinai J. Med. (Ny.)46 (1979), 328–332.
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Salazar, J., Vaquero, J., Martinez, P. et al. Clinical and CT scan assessment of benign versus fatal spontaneous cerebellar haematomas. Acta neurochir 79, 80–86 (1986). https://doi.org/10.1007/BF01407449
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DOI: https://doi.org/10.1007/BF01407449