A Case Report of Recurrent and Disseminated Cerebellar Hemangioblastoma

The authors present a rare case of recurrence and dissemination following total removal of solitary cerebellar hemangioblastoma. A 48-year-old male patient who had been diagnosed as having cerebellar hemangioblastoma was admitted to our hospital. After two consecutives successful removal of the tumor, there were several years in which he was free from symptoms, but recurrence and dissemination was found on both cerebellar hemispheres and brain stem. Using previous reports, we will demonstrate the clinical and pathological factors which are responsible for recurrence or dissemination of cerebellar hemangioblastoma. So we suggest that in cases the possibility of recurrence and dissemination are associated with the preidictors, it may be necessary to have follow up examinations routinely for a prolonged period.

Surgery of Cerebral Aneurysms in Comatose Patients

Neurological grade on admission is an important prognostic factor for aneurysmal patients. The decision for operation in comatose patients with ruptured aneurysm is difficult and remains controversial. Recent literatures tend to emphasize the benefit of operative treatment for these patients because of the higher mortality of the patients who were managed conservatively. We performed early surgery in ten comatose aneurysmal patients combining lumbar drainage, intravenous and cisternal nimodipine therapy, and intermittent brain retraction. Among these ten patients, four showed survival over three months. We suggest that early surgery with aggressive postoperative management should be considered in comatose aneurysmal rupture patients for life-saving.