The clinical study of surgical treatment value to the deep coma patients with spontaneous cerebellar hemorrhage

Abstract

Objective To investigate the surgical treatment value to the deep coma patients with spontaneous cerebellar hemorrhage. Methods The clinical manifestations were recorded and analyzed in 43 patients suffering from cerebellar hemorrhage. Thirty-two patients(surgical treatment group)were treated with suboccipital decompression, clot evacuation and external ventricular drainage, and 11 patients(conservative treatment group)were managed conservatively. The level of consciousness was evaluated with Glasgow coma scale(GCS), and GCS scores of all enrolled patients was less than 5. Outcome was assessed with Glasgow outcome scale(GOS)at 6 months after onset. Results At 6 months after onset, the fatality rate in surgical treatment group was 31.25%(10/32), in conservative treatment group was 6/11, and there was no significant difference(χ2 = 1.04, P = 0.310). The rate of bad outcome(GOS 1-3 scores)in surgical treatment group was 75.00%(24/32), in conservative treatment group was 11/11, and there was no significant difference(χ2= 2.40, P = 0.120). In the patients of more than 60 years old, the rate of good outcome between surgical treatment group and conservative treatment group had no significant difference: 5/16 vs. 0, χ2 = 6.00, P = 0.060. Conclusions Although fatality rate is lower, the long-term prognosis couldn' t be improved by surgical treatment in the cerebellar hemorrhage patients with GCS ≤ 5 scores when the brainstem function isn' t evaluated. Key words: Brain hemorrhage, traumatic; Coma; Surgical procedures, operative; Conservative treatment