Stereotactic Evacuation of Spontaneous Intracerebellar Hemorrhage

ABSTRACT

The incidence of spontaneous cerebellar hemorrhage is a range of between 0.3% and 0.7% in several large series and accounts for 10% of all intracranial hemorrhages. The course and prognosis of spontaneous intracerebellar hemorrhage, regardless of treatment, is poor. The Cosman-Robert-Wells(CRW) stereotactic instrument is recently developed modification, based on an arc-radius design, of the Brown-Roberts-Wells(BRW) stereotactic frame utilizing the exising fixation and fiducial components of the BRW stereotactic system localize and verify target data. During the year of 1989 through 1991, 25 patients with spontaneous cerebellar hemorrhage operated on using CRW stereotactic instrument and fibrinolysis. The age incidence was most frequent in 7th decade. 19 cases(76%) obtained a favorable outcome after operation and 4 cases(16%) death. 2 cases subsequently developed postoperative rebleeding and a case infection. The short operating time, the relatively low risk involved, and the lack of danger to healthy brain support the use of CT-guided stereotactic removal and fibrinolysis. In our opinion, CT guided sterotactic removal is simple, effective and safe method for spontaneous cerebellar hematoma.