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[Spontaneous Cerebellar Hematoma]

Authors :
UCL - (MGD) Service de neurochirurgie
UCL - (SLuc) Service de neurologie
UCL - MD/NOPS - Département de neurologie et de psychiatrie
UCL - MD/CHIR - Département de chirurgie
Gilliard, Claude
Mathurin, P.
Passagia, JG.
Kallel, S.
Thauvoy, Christian
Stroobandt, Guy
UCL - (MGD) Service de neurochirurgie
UCL - (SLuc) Service de neurologie
UCL - MD/NOPS - Département de neurologie et de psychiatrie
UCL - MD/CHIR - Département de chirurgie
Gilliard, Claude
Mathurin, P.
Passagia, JG.
Kallel, S.
Thauvoy, Christian
Stroobandt, Guy
Source :
Neurochirurgie, Vol. 36, no. 6, p. 347-353 (1990)
Publication Year :
1990

Abstract

Forty spontaneous cerebellar hematomas have been observed in 39 patients whose age ranged from 13 to 82 years, 26 being older than 60. Arterial hypertension is the most frequent aetiological factor. Amongst the other causes, vascular malformations, which may also be present in older people, anticoagulant therapy, metastatic tumor, sepsis were found; one case remained unsolved. Diagnosis is no longer a challenge since the introduction of C.T. scan, whilst M.R.I. may give most valuable informations concerning aetiology, especially when a vascular malformation is present. In this study, the influence of the hematoma size and of hydrocephalus on consciousness was demonstrated; development of hydrocephalus is favoured by the size and by a rather median location of the hematoma. In the future, M.R.I. should give better precisions concerning an eventual extension of the hemorrhage to the brainstem. The purpose of surgical treatment is twofold: alleviating brainstem compression and correcting hydrocephalus; yet, divergent opinions have been put forward in retrospective studies, concerning evacuation of the hematoma and drainage of hydrocephalus. In this series, direct attack doesn't seem to be indicated in hematomas less than 3,5 cm diameter, unless a causal lesion has to be removed. The ideal moment for hematoma evacuation is, finally, dictated by the clinical status and its evolution; however, the authors prefer, if possible, to delay it for at least 48 hours. Amongst the 39 patients, 14 deceased; of the 25 survivors, 19 were autonomous, 7 being nearly asymptomatic, 6 patients remained handicapped. Consciousness is a main pronostic factor, whilst coma in the first hours has a clearly unfavourable significance.

Details

Database :
OAIster
Journal :
Neurochirurgie, Vol. 36, no. 6, p. 347-353 (1990)
Notes :
French
Publication Type :
Electronic Resource
Accession number :
edsoai.on1130558245
Document Type :
Electronic Resource