Treatment Of Cerebellar Hemorrhage Research Articles

Is External Ventricular Drainage Life-Saving in Cerebellar Hemorrhages?

Background: The treatment of cerebellar hemorrhage (CH) may be different surgery or conservative according to the hematoma volume, compression of vital structures or hydrocephalus existence. In the present study, the authors investigated the risk factors, the indications and the situation of external ventricular drainage (EVD) on the treatment line. Methods: 63 pure cerebellar hemorrhage patients were enrolled in the study. 36 cases underwent surgery; the other 27 were received conservative treatment. 15 and 13 cases received EVD in both groups. Hospital stay and mortality rates were investigated. Results: 4 cases in the conservative group underwent surgery secondary to treatment failure. Both of the groups had equal rates of morbidity and mortality. On the other hand, the group that received surgical intervention had shorter median hospital stay. The EVD does not seem to be life-saving at first but it gives time for preparing for surgery. Conclusions: We found that CH was strongly associated with early hydrocephalus and mortality. The early diagnosis and surgical evacuation of the mass are mandatory and life-saving if hematoma is larger than 10 ml. The EVD may not being a life-saving instrument but majorly it may be a time earning device if acute hydrocephalus present.

Surgical Treatment for Occipital Condyle Fracture, C1 Dislocation, and Cerebellar Contusion with Hemorrhage after Blunt Head Trauma.

Occipital condyle fractures (OCFs) have been treated as rare traumatic injuries, but the number of reported OCFs has gradually increased because of the popularization of computed tomography (CT) and magnetic resonance imaging (MRI). The patient in this report presented with OCFs and C1 dislocation, along with traumatic cerebellar hemorrhage, which led to craniovertebral junction instability. This case was also an extremely rare clinical condition in which the patient presented with traumatic lower cranial nerve palsy secondary to OCFs. When the patient was transferred to our hospital, the occipital bone remained defective extensively due to surgical treatment of cerebellar hemorrhage. For this reason, concurrent cranioplasty was performed with resin in order to fix the occipital bone plate strongly. The resin-made occipital bone was used to secure a titanium plate and screws enabled us to perform posterior fusion of the craniovertebral junction. Although the patient wore a halo vest for 3 months after surgery, lower cranial nerve symptoms, including not only neck pain but also paralysis of the throat and larynx, improved postoperatively. No complications were detected during outpatient follow-up, which continued for 5 years postoperatively.

Clinical comparative study on different surgical methods for treatment of cerebellar hemorrhage

Objective To discuss the clinical effect of different surgical methods for treatment of cerebellar hemorrhage.Methods 62 patients with spontaneous cerebellar hemorrhage were randomly divided into 2 groups with 31 cases in each group.Observation group was given posterior fossa hematoma evacuation,while control group was given cerebellar decompression.Clinical effect and postoperative complications of the 2 groups were compared.Results Clinical effective rate of observation group was obviously higher than that of control group (87.10％ vs 61.29％); 2 cases (6.45％) of intracranial infection and 1 case (3.23％) of incision infection occurred in observation group and no severe complications like leakage of cerebrospinal fluid,subcutaneous hydrops and false cyst were found in observation group (compared with control group,P ＜ 0.05).Conclusion Posterior fossa hematoma evacuation for treatment of spontaneous cerebellar hemorrhage has accurate clinical effect and few complications.Early surgical treatment can improve clinical effect and prognosis. Key words: Hematoma evacuation; Ventricular drainage; Cerebellar hemorrhage; Clinical analysis