[Cerebellar hemorrhage. Clinico-topographic correlations and therapeutic indications].
Spontaneous cerebellar hemorrhages are more easily recognized since the large use of CT scanner. In this series of 28 cases, they represent 9% of all spontaneous intra-cranial hemorrhages. Three main categories may be described. Small hematomas (less than 3 cm) are located in the postero-medial part of the cerebellum (9 cases): they are difficult to recognize, due to their limited clinical signs; their evolution is spontaneously favorable. Larger hematomas (more than 3 cm) represent two thirds of our clinical cases. When situated near the midline (7 cases) stupor or coma are quite constant, as neurovegetative signs; differentiating this type of case from brain-stem hemorrhages is difficult; prognosis is severe as even with surgery; there is a high mortality rate. When located more laterally (12 cases), their evolution is less acute: consciousness disturbances do not generally occur at the onset, whereas cerebellar disfunction is quite obvious; contrary to midline cases, these, when operated upon at an early stage, show a high success rate. If operation is delayed, the prognosis is much more serious due to the mass effect of this lesion in the posterior fossa. This is clearly demonstrated by CT scan which consistently shows displacement of the 4th ventricle with hydrocephalus of the lateral ventricles.
D000328:Adult; D000368:Aged; D002526:Cerebellar Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000628:therapy; D002543:Cerebral Hemorrhage / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000628:therapy; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D011379:Prognosis; D014057:Tomography, X-Ray Computed
Hémorragies cérébelleuses. Confrontations clinico-topographiques et indications thérapeutiques.