Traumatic acute intracerebellar hematoma.
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The case of a 62-year-old male with acute development of a traumatic intracerebellar hematoma, which was identified on serial CT scans, is reported. The patient fell and struck his occiput when he was involved in a traffic accident on June 25, 1988. He complained of headache and vomited, and was transferred to this hospital within one hour after the accident. On admission, he was alert and well oriented. Plain skull roentgenogram showed a right occipital linear fracture. The initial CT scan showed a small high density area in the right cerebellar hemisphere suggesting a hematoma, associated with hemorrhage in the IVth ventricle and subarachnoid space. Gradually, the patient became drowsy and began vomiting frequently. CT scan performed 3 hours after injury revealed an increased volume of hematoma in the right cerebellar hemisphere with slight shift of the IVth ventricle to the opposite side. Emergency posterior fossa craniectomy was then performed 5 hours following injury and the hematoma was totally evacuated with debridement of the contused cerebellar hemisphere. The postoperative course was uneventful. At follow-up examination 4 months later the patient was found to be leading a normal life without any neurological deficit. Traumatic acute intracerebellar hematomas, unassociated with subdural or epidural hematoma of the posterior fossa, are relatively rare. Early diagnosis and management should be made so as not to result in fatal brain stem injury.
- 一般社団法人 日本救急医学会の論文
一般社団法人 日本救急医学会 | 論文
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