Abstract
We present a case of acute cerebellar infarction with excellent recovery by surgical treatment. The patient was a 33-year-old female who was admitted to another hospital complaining of sudden onset of headache and weakness. On the following day, her level of consciousness deteriorated rapidly and she was transferred to our hospital.
She was semicomatose. The right pupil was slightly larger than the left and the reaction to light was bilaterally brisk. A CT scan revealed a low density area in the left cerebellar hemisphere, disappearance of the fourth ventricle and hydrocephalus. A bilateral brachial angiogram demonstrated a hypovascular mass lesion in the posterior fossa.
The left posterior inferior cerebellar artery was not visualized. We diagnosed as a cerebellar infarction with severe brain edema. She became comatose after angiography. Suboccipital craniectomy was immediately performed and the infarcted cerebellar hemisphere was partially resected. She awoke and was able to respond to some orders on the first postoperative day. Four months later she was discharged home with slight diplopia and ataxia. At preset (three years after surgery) she is in good health without neurologic deficits.
Cerebellar infarction is sometimes fatal due to brainstem compression. Suboccipital decompression is effective for these cases. Even if the patient is comatose before sugery, good operative results can be expected. Surgical treatment is recommended for acute cerebellar infarction with brainstem compression,
