Cerebellar Hemangioblastoma:Hemorrhage as an Initial Presentation: Case Report

A rare case of a spontaneous intracerebellar hemorrhage from a solid cerebellar hemangioblastoma is reported with review of articles. The cerebellar hemangioblastoma was strongly suspected in the postoperative brain computerized tomography and vertebral angiography. It was successfully removed by second operation and confirmed histologically.

A Clinical Analysis of Ventriculoperitoneal Shunt

The author analyzed 73 patients with hydrocephalus, who were managed by ventriculoperitoneal shunt in recent 5 years at Chung-Ang University Hospital. The causes of hydrocephalus were brain tumor(23%), head trauma(21%), aqueductal stenosis(16%), myelomeningocele(4%), spontaneous subarachnoid hemorrhage (14%), meningitis(12%) and idiopathic normal pressure hydrocephalus(10%). Their symptoms and signs were gait disturbance(39 patients), mental change(31 patients), papilledema(30 patients) and urinary incontinence(20 patients). Gait disturbance of 39 patients was improved in 23 patients(59%), but visual acuity was improved in only 1 patient. The brain computed tomography showed "roundness" of frontal horns(100%), moderate ventricular dilatation(61%), obliteration of cerebral sulci(68%) and periventricular low densities(56% ). Accu-Flo distal slit valve system was applied in all cases and medium pressure valve(closing pressure: 5-9 cm H20) was selected in 65 patients. Twenty reoperations were done in 16 patients and their causes were shunt malfunction(13 cases) and infection(4 cases) . Ventricular puncture was done through the Keen's point in all cases and ventricular catheter tip was inserted into the contralateral frontal horn in 30 cases, but there was no shunt malfunction in those patients.