Haematoma of the tentorium cerebelli - new pathology or new prognostic factor in neurotraumatology? A preliminary report.
OBJECTIVE
The aim of the study was to establish the frequency of haematoma of the tentorium cerebelli, to elucidate the possible pathomechanism related to its formation, and to assess its clinical significance.


METHODS
84 patients with haematoma of the tentorium cerebelli were selected out of the 1159 patients treated in our Department from 2003 to 2005 due to craniocerebral trauma. All patients had computed tomography (CT) performed on admission. In selected cases, magnetic resonance imaging (MRI) was performed. Additionally, 4 autopsies were performed using a special technique for better recognition of blood location within the region of the tentorium.


RESULTS
The study group comprised 61 men (73%) and 23 women (age range: 18-84 years). Fall on the occiput was the main cause of trauma. The clinical status of patients was rather serious (53% of patients scored below 8 pts on the Glasgow Coma Scale on admission), as was the clinical course (39% of patients eventually died). The following co-existing pathologies were found in CT: traumatic subarachnoid haemorrhage and cerebral contusion (60% of patients), subdural haematoma (45%), intracerebral haematoma (31%), pathology in posterior fossa (12%), and epidural haematoma (8%). MRI revealed subdural collection of blood above or below the tentorium or the subarachnoid haemorrhage beneath the occipital lobes and/or over the cerebellar hemisphere.


CONCLUSIONS
The progress in neuroimaging, especially in CT scanning, enables haematoma of the tentorium cerebelli to be discerned as a distinct clinical entity.
Moskała
Marek
M
Department of Neurosurgery, Jagiellonian University Medical Collge, Kraków, Poland.
Polak
Jarosław
J
Moskała
Artur
A
Kleinrok
Krzysztof
K
Zawiliński
Jarosław
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020201:Brain Hemorrhage, Traumatic / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D002531:Cerebellum / Q000473:pathology; D005260:Female; D006406:Hematoma / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014057:Tomography, X-Ray Computed