[Cerebellar hematomas: a surgically treatable stroke].
BACKGROUND
Spontaneous cerebellar hematomas make up nearly 10% of the intracranial intraparenchymatous hemorrhages. In recent years several algorithms have been published for the management of these patients.


OBJECTIVE
To study the type of treatment, conservative or operative, and the main prognostic factors.


METHODS
We present a retrospective analysis of 52 cases of spontaneous cerebellar hematomas diagnosed over the past 10 years in the Hospital General de Galicia. We studied the clinical and radiological factors with the greatest effect on prognosis and the approach to treatment.


RESULTS
We found a male/female ration of 2/3. The age of 90.3% of our patients was over 60 years. Arterial hypertension had previously been diagnosed in 55.7% of the cases. The clinical picture was characterized by the profile of a stroke with headache (90.3%), vomiting (63.4%) and impaired consciousness (50%) being the commonest presenting symptoms. The most important factors in prognosis were the level of consciousness and the size of the hematoma. The prognosis was worse in cases with hydrocephalus, intraventricular hemorrhage or extension of the hematoma towards the midline. Neither age, sex nor the previous diagnosis of arterial hypertension were of importance in prognosis. Mortality was 25%.


CONCLUSIONS
The spontaneous cerebellar hematomas typically affect patients over the age of 60 years and present with headache and vomiting of sudden onset. In our series the major prognostic factors were the size of the hematoma and level of consciousness, and treatment was given in accordance with this.
González-García
J
J
Servicio de Neurocirugía, Hospital Clínico Universitario, Universidad de Santiago de Compostela, Santiago de Compostela, La Coruña, España.
Gelabert-González
M
M
García-Allut
A
A
Fernández-Villa
J M
JM
López-García
E
E
García-Pravos
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D000925:Anticoagulants / Q000627:therapeutic use; D001925:Brain Damage, Chronic / Q000209:etiology; D019090:Case Management; D002526:Cerebellar Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000453:epidemiology / Q000601:surgery*; D002543:Cerebral Hemorrhage / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000453:epidemiology / Q000601:surgery*; D003131:Combined Modality Therapy; D003244:Consciousness Disorders / Q000209:etiology; D003399:Craniotomy; D005260:Female; D015600:Glasgow Coma Scale; D006261:Headache / Q000209:etiology; D006406:Hematoma / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery* / Q000628:therapy; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology; D006973:Hypertension / Q000150:complications; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011379:Prognosis; D011859:Radiography; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D016896:Treatment Outcome; D014839:Vomiting / Q000209:etiology
D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors
Hematomas de cerebelo: un ictus con tratamiento quirúrgico.