Hypertensive Cerebellar Hemorrhage : Its Symptoms and Management

概要

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A series of 18 patients with hypertensive cerebellar hemorrhages diagnosed with computed tomography (CT) is described. The cliqical course appeared to fall into three groups. Group I (56%) did not exhibit conscnousness disturbances and improved spontaneously. Group II (22%) developed gradual deterioration of consciousness. Group III (22%) became comatose within 12 hours and developed signs of brain stem dysfunction. The CT findings reflected the three clinical groups. The CT of Group I revealed a small hematoma (≦ 24 mm) with or without ventricular hemorrhage. The scans of Group II demonstrated hematomas of moderate volume (34〜52 mm) with a partial defect of the pertmesencephalic cisterns. The CT of Group III showed a large hematoma ( ≧43 mm) with massive ventricular hemorrhaging and obstructive hydrocephalus. Severe mass effects on the brain stem were also seen. The patients of Group I should be treated by conservative therapy and Group II by emergent suboccipital craniectomy and evacuation of the hematoma. Surgical indication for the patients in Group III could not be determined.
日本脳神経外科学会の論文
1981-07-15