Surgical treatment of spontaneous cerebellar hemorrhage

Tai Ngar Lui, David J. Fairholm, Ta Fu Shu, Chen Nen Chang, Shih Tseng Lee, Han Rong Chen

Research output: Contribution to journalArticle

51 Citations (Scopus)

Abstract

Spontaneous cerebellar hemorrhage accounts for 5%-10% of intracerebral hemorrhage in most series. From June 1979 to June 1983 we had 26 surgical cases of spontaneous cerebellar hemorrhage. There were 15 men and 11 women. The typical history was sudden onset of severe headache, vomiting, dizziness, and inability to walk. Disturbance of consciousness was usually a late feature. Common signs were truncal ataxia, nystagmus, conjugate eyeball deviation, small miotic pupils with or without light reflex and abducens palsy. Surgical indications are (a) disturbance of consciousness, (b) signs of brainstem compression and (c) hematoma with transverse diameter greater than 3 cm. The overall surgical mortality was 34.6%. Twenty-two patients underwent suboccipital craniectomy to evacuate hematomas with or without ventriculostomy; mortality rate was 27%. Four patients underwent ventriculostomy only; mortality was 75%. Causes of death were (a) brainstem failure, six patients; (b) airway obstruction, one patient; (c) chest infection, one patient; (d) chronic renal failure, one patient. Conclusion: (a) suboccipital craniectomy to evacuate the hematoma is the most effective procedure where treatment is indicated; (b) the clinical recovery of the survivors show that 31% return to work, 38% are moderately disabled but take care of themselves, and 31% remain dependent on others; (c) deeply comatose patients may still benefit from early operation.

Original languageEnglish
Pages (from-to)555-558
Number of pages4
JournalSurgical Neurology
Volume23
Issue number6
DOIs
Publication statusPublished - 1985
Externally publishedYes

    Fingerprint

Keywords

  • Cerebellar hemorrhage
  • Glasgow outcome scale
  • Spontaneous intracranial hematoma
  • Sub-occipital craniectomy
  • Ventriculostomy

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Lui, T. N., Fairholm, D. J., Shu, T. F., Chang, C. N., Lee, S. T., & Chen, H. R. (1985). Surgical treatment of spontaneous cerebellar hemorrhage. Surgical Neurology, 23(6), 555-558. https://doi.org/10.1016/0090-3019(85)90002-3