Traumatic Intracerebellar Hematomas

OBJECTIVE: We report six patients with traumatic intracerebellar hematomas between 1997 and 2003 at our hospitals. METHODS: Each data about patients' clinicoradiologic findings, management, and outcomes, which were retrospectively reviewed. RESULTS: All patients had skull fracture on occiput and five patients with large hematomas(three cm or greater) were operated on. In the results of surgery, three patients were good outcome but two patients were fatal due to compression of brain stem. One patient with small hematoma (1.5cm) was treated conservatively and recovered. CONCLUSION: In our cases, the clinical course and prognosis of traumatic intracerebellar hematoma were grave. The results of this study support that early diagnosis based on strict observation in patients with occipital fracture will lead to best results.

Spontaneous Intracerebellar Hematoma

Twenty-five patients with spontaneous intracerebellar hematoma were analyzed, who had been admitted to Jeonju Jesus Hospital from 1982 to 1985. All cases were diagnosed by CT scan and the amount of the hematoma was assessed by the largest diameter and the height as large, moderated, and small. Three clinical types were defined to evaluate the method of treatment and the outcome. All twelve acute cases were operated and seven were dead-five from brainstem failure, one from rebleeding, and one from chest infection. All chronic cases were treated conservatively to yield good results. Of seven subacute cases, five were operated and two died. Overall mortality was 36% and surgical mortality was 53%. To avoid considerable loss of potential recovery, it is suggested that prompt confirmation of the intracerebellar hematoma by CT scan, emergency surgical management, proper pre-and post-operative care results in better prognosis in cases of this not-uncommon-not-incurable disease.