Abstract
Spontaneous cerebellar hematomas represent 5 to 13% of all cases of spontaneous intracranial hemorrhage. The main controversy involves deciding which cases require surgical evacuation of the hematoma versus other options, such as ventricular drainage only or conservative treatment. Furthermore, because the clinical course is variable in some cases, timing of such treatment should be carefully considered. The duration from the onset of hemorrhage also plays an important role in prognosis and recovery of the patient. Both the clinical presentation and subsequent course vary among cases. Unpredictable rapid deterioration in consciousness levels has been recognized. The majority of patients with such decline in consciousness experience the deterioration primarily within 72 hrs after onset. Acute presentation was observed to be correlated with poor outcomes. In our report, the first case presented with sudden onset of headache in the right frontal region of head with vertigo. He came to hospital within 6 hours of onset. However, the second case had an onset of symptoms around 72 hours before the presentation.
Highlights
The posterior cranial fossa (PCF) is the deepest and most confined space in the skull
Spontaneous cerebellar hematomas represent 5 to 13% of all cases of spontaneous intracranial hemorrhage
CT Angiography of Brain was done to rule out any other vascular abnormalities and it inferred normal angiographic findings except hypoplastic Left Posterior Communicating Artery. His CBC, ESR, Coagulation Profile, Immunology, RBS, ECG, RFT and LFT reports were within normal ranges. He was immediately planned for surgery and emergency Craniotomy and Evacuation of Posterior Fossa Hematoma with External Ventricular Drainage (EVD) insertion was performed under General Anesthesia
Summary
Around 60 ml of Acute Blood Clots were removed from the Right Cerebellum and EVD was inserted up to third ventricle to prevent possible hydrocephalus due to obstruction at fourth ventricle He was egneuro, Volume 03, Issue 01, 2021 managed post operatively with IV Antibiotics, IV Fluids, Analgesic, PPI, IV Steroids and Antihypertensive. The patient is non-hypertensive, nondiabetic and has no other chronic illnesses except he had an episode of raised Blood Pressure, recorded 260/120 one day back for which he was managed in local medical store He doesn’t smoke and doesn’t consume alcohol. His CBC, ESR, Coagulation Profile, Immunology, RBS, ECG, RFT and LFT reports were within normal ranges He was planned for emergency surgery and underwent External Ventricular Drainage (EVD) insertion with Craniotomy and evacuation of Posterior fossa hematoma under General Anesthesia. Despite all the aggressive management, he had no significant improvement in consciousness level
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