[Clinical study of hypertensive cerebellar hemorrhage: surgical indication and measurement of volume of hematoma]

Abstract

There have been a few reports available for determining surgical indications in hypertensive cerebellar hemorrhage based on volume of hematoma on computerized tomography (CT). The authors then studied the clinical results of hypertensive cerebellar hemorrhage, and the surgical indication based on clinical findings and volume of hematoma on CT scan was considered. Forty-five patients with hypertensive cerebellar hemorrhage diagnosed by CT scan who were hospitalized to Matsue Red Cross Hospital from January 1980 up to December 1986 were studied. The 25 male and 20 female patients ranged in age from 52 to 85 years, and 16 of them were operated on. The results were as follows: 1) The Kanaya's neurological grading tended to be high in the patients with cerebellar vermis hemorrhage or a large volume of hematoma (greater than or equal to 30 ml). 2) In patients with grade I or II and a moderate volume of hematoma (15-30 ml), the patient complicated with hydrocephalus should be treated with ventricular drainage. The patients with grade III and IVa should be treated with surgical therapy (suboccipital craniectomy and evacuation of the hematoma). The patients with cerebellar vermis hemorrhage should be treated with surgical therapy. The patients with a large volume of hematoma (greater than or equal to 30 ml) should be treated with surgical therapy. The patients with grade IVb and V should not be treated actively because the prognosis is bad.(ABSTRACT TRUNCATED AT 250 WORDS)