INDICATION TO SURGICAL-MANAGEMENT OF CEREBELLAR HEMORRHAGE

Few reports have compared patients operated for cerebellar infarcts wi th those operated for cerebellar hemorrhage. Considering our previous paper about patients with massive cerebellar infarcts, we report on ou r surgical experience with five patients with cerebellar hemorrhage. T he indication for operation was decreased consciousness with signs of brainstem compression. In all patients hydrocephalus was absent or mil d, as opposed to patients with cerebellar infarcts. Suboccipital crani otomy with hematoma evacuation was therefore the surgical procedure of choice. The outcome was worse than in patients with cerebellar infarc ts. We conclude that depressed mental state in cerebellar hemorrhage i s mainly due to pressure of the cerebellum on the activating reticular system of the brainstem. The surgical approach to patients with bleed ing in the cerebellum differ somewhat from that of patients with cereb ellar infarcts in timing and kind of first choice procedure. (C) 1998 Elsevier Science B.V. All rights reserved.