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2015 ; 17
(3
): 185-93
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Management and Outcome of Spontaneous Cerebellar Hemorrhage
#MMPMID26523254
Han J
; Lee HK
; Cho TG
; Moon JG
; Kim CH
J Cerebrovasc Endovasc Neurosurg
2015[Sep]; 17
(3
): 185-93
PMID26523254
show ga
OBJECTIVE: Spontaneous cerebellar hemorrhage (SCH) is less common than
supratentorial intracerebral hemorrhage. This study investigated the treatment of
SCH and the relation between its clinical and radiological manifestation and
outcome. MATERIALS AND METHODS: We presented a SCH management protocol in our
institute and analyzed the clinical and radiological findings in 41 SCH patients.
The outcomes of each method (surgery and conservative treatment) were compared
among patients with initial Glasgow Coma Scale (GCS) score of 9-13 and hematoma
volume greater than 10 mL. RESULTS: Two (4.9%), 16 (39%), and 23 (56.1%) patients
had an initial GCS score of 3-8, with 3-8, 9-13, and 14-15, respectively. Initial
GCS score showed significant correlation with Glasgow Outcome Scale (GOS) score
(p = 0.005). The mean largest hematoma diameter was 3.2 ± 1.5 cm, and the mean
volume was 11.0 ± 11.5 mL. Both of them showed significant inverse correlation
with GOS score (p < 0.001). Among patients with an initial GCS score of 9-13 and
hematoma volumes greater than 10 mL, 3 (50%) had good outcome and 3 (50%) had
poor outcome in the surgical, and all of those in the conservative treatment
group had poor outcomes. The outcome distribution differed significantly in the
surgical and conservative groups (p = 0.030). CONCLUSION: Initial GCS score and
largest hematoma diameter and volume on brain computed tomography are important
determinants of outcome in SCH patients. The surgery group showed better outcome
than the conservative treatment group among those with an intermediate
neurological status and large hematomas.