ABSTRACT
The term spontaneous intracerebellar hematomas means bleeding into cerebellar parenchyma without trauma. Cerebellar hemorrhage represents 10% of all spontaneous cerebral hemorrhage. Twenty patients with spontaneous intracerebellar hemorrhage were the material of this study to evaluate the outcome of both surgical and medical treatment modalities. Patient were divided into two groups according to the general condition of the patients and [the Hunt and Hess scale] and GCS for the level of consciousness, the first group contains five patients were treated conservatively, and the other fifteen patients were operated upon through a sub occipital craniectomy; and ventricular drainage. After resuscitation all cases were examined clinically after taking the history briefly, complete radiological investigations [CT brain scan MRI and MRA]. Evaluation of pathological causes, risk factors, clinical presentations, radiological findings, different management decisions and discussing factors affecting its outcome. Spontaneous intra cerebellar hemorrhage is a common neurosurgical emergency occurring with no much differences in both sexes; Uncontrolled systemic arterial hypertension, diabetes mellitus, and smoking were the commonest risk factors. Altered consciousnesses, acute sever headache, cerebellar manifestations, brainstem, manifestations, and hemiplegia was the commonest clinical findings. Intraventricular hemorrhage extension, hydrocephalic changes and obliteration of the quadrigeminal cistern were poor prognostic signs. The early the detection and management the best the outcome is. In case of large and rapid progressive increase in size of the IC hematoma needs rapid emergent surgical evacuation, and CSF drainage [in case of hydrocephalic changes]. should be on emergency bases too. The factors influencing the neurosurgical outcome in cases of spontaneous intra cerebellar hemorrhage are: The age of the patient and his general condition on admission.The early suspect and detection to save time avoiding deterioration of consciousness and neurological status. The state of consciousness at time of presentation and preoperatively that the patients with GCS 8 had a worse outcome. *The radiological findings the larger sized hematoma, the hydrocephalic changes. and obliteration of the quadrigeminal cistern the worse the prognosis, and are indicators for rapid surgical evacuating of the hematoma, and /or ventricular drainage. The more stable clinical course the best the results is. Rapid deterioration of the conscious level show bad diagnosis