良性小脳出血の2症例

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Two patients with cerebellar hemorrhage with benign clinical course were reported and the importance of computed tomography (CT) for the correct diagnosis is emphasized. Case 1 : A 66-year-old woman with a history of hypertension had an attack of vertigo, nausea, vomiting and dull headache. On admission she was alert and showed right Homer's sign, right 6th nerve palsy, increased left deep tendon reflex, and nystagmus on right lateral gaze. Cerebellar function was normal. Despite the initial clinical impression of brainstem infarction due to the absence of cerebellar dysfunction, CT scan revealed a right carebellar hematoma. Recovery occurred gradually with medical treatment and CT scan 25 days after the onset showed a complete resolution of the cerebellar hematoma. Case 2 : A 52-year-old woman, with a history of hypertension and an old cerebral thrombosis, suddenly experienced vertigo, nausea and vomiting, but no headache. The patient was somnolent but the neurological examination revealed no focal abnormality except mild left hemiparesis which was due to the old cerebral thrombosis. The initial clinical impression was that of the vertebrobasilar insufficiency, but CT scan showed a left cerebellar hematoma. She recovered gradually and CT scan 22 days after the onset showed a complete resolution of the cerebellar hematoma. Our experience with these two cases suggests that patients with benign cerebellar hemorrhage may lack the cerebellar signs or headache and be clinically misdiagnosed as brainstem infarction or vertebrobasilar insufficiency. In such cases the correct diagnosis could only be made by CT scan.
北里大学の論文
1981-08-31

良性小脳出血の2症例

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