[Spontaneous cerebellar haematoma. Diagnosis, management and follow-up in 18 patients].
OBJECTIVE
Describe eighteen patients with spontaneous cerebellar haematoma (SCH), their diagnosis, management and outcome.


METHODS
18 patients were seen at the Hospital de Especialidades CMN "La Raza" between January 2001 and July 2003. Patients were male and female over 16 years that showed signs compatible with SCH. Fourth ventricle compression, neurological status, hydrocephalus, concomitant diseases, management and postoperative status were assessed. Fourth ventricle compression was divided in three stages. Management included: 1) conservative approach, 2) craniectomy and haematoma drainage, 3) craniectomy haematoma drainage and ventricular derivation, 4) ventriculostomy and 5) absence of treatment.


RESULTS
SCH was observed for over six hours in 11 patients (62%). Systemic hypertension was present in 13 patients (72%), hydrocephalus in 12 (66%), five patients displayed a favourable outcome and were able to lead independent lives (28%), three patients (17%) had a guarded outcome, dependent on others for daily living skills and 10 patients died.


CONCLUSIONS
SCH is a medical and surgical emergency. Neurological status and degree of fourth ventricle compression are the most important factors on which to base clinical management and infer prognosis.
Alvarez-Betancourt
Leonardo
L
Servicio de Neurocirugía, Hospital de Especialidades, Centro Medico Nacional La Raza, IMSS, México DF, México. azbtlo@hotmail.com
Ramírez-Mendoza
Arturo
A
López-Ortega
Salvador José
SJ
Caldera-Duarte
Agustín
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002528:Cerebellar Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006406:Hematoma / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D020300:Intracranial Hemorrhages / Q000175:diagnosis* / Q000628:therapy*; D008297:Male; D008875:Middle Aged