Clinical outcome following surgical treatment for bilateral cerebellar infarction.
OBJECTIVE
To analyze the initial clinical and radiological findings, the surgical treatment, and the clinical outcome following surgical decompression in patients with space-occupying bilateral cerebellar infarction.


METHODS
Ten patients with expansive bilateral cerebellar infarction and decreased level of consciousness were operated with suboccipital craniectomy, removal of the infarcted tissue, and placement of external ventricular drainage. Long-term outcome was assessed using the modified Rankin scale (mRS).


RESULTS
Mean Glasgow coma scale (GCS) score before surgery was 8.9 ± 3.3 and improved to 12.6 ± 3.6 at discharge. At the long-term follow-up (median 57.6 months), six patients had a favorable outcome (mRS 1.3 ± 0.8). Four patients, all with an associated brain stem infarct, had a poor outcome.


CONCLUSIONS
In the absence of brain stem infarcts, surgical treatment resulted in a favorable clinical outcome and should be considered a treatment option for patients with expansive bilateral cerebellar infarction.
Tsitsopoulos
P P
PP
Department of Neurosurgery, Uppsala University Hospital, Uppsala, Sweden. par_tsits@yahoo.gr
Tobieson
L
L
Enblad
P
P
Marklund
N
N
D000328:Adult; D000368:Aged; D020520:Brain Infarction / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D002526:Cerebellar Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D002531:Cerebellum / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D003399:Craniotomy; D019299:Decompression, Surgical; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012720:Severity of Illness Index; D016896:Treatment Outcome