Abstract
The authors present 2 cases of spontaneous cerebellar hemorrhage in children who resulted in poor outcome, and the 47 previous cases reported in the literature were reviewed. Case 1 : An 8-year-old girl had sudden episode of headache and vomiting, and was admitted to our department with coma demonstrating acute respiratory failure 2 hours after the first attack. A large hematoma was pointed out on the vermis with obstructive hydrocephalus on CT scan. The hematoma was evacuated, but post operative CT scans showed diffuse hypoxic change on the bilateral cerebral hemispheres. Inspite of intensive management contained brain hypothermia therapy, the patient was expired. Case 2 : A 9-year-old boy was admitted with coma and apnea 2 hours after the first attack. A CT scan demonstrated massive intracerebellar hematoma compressed the quadrigeminal cistern completely. The patient was expired without surgical intervention because of its critical vital signs. No bleeding source was identified in both cases. Spontaneous cerebellar hemorrhage is uncommon in children, and favorable outcome is obtained by surgical intervention, especially in the CT era, but poor outcome patients exist certainly. Poor prognosis is supposed to be concerned with 1)coma state, 2)compressed quadrigeminal cistern on CT scan, 3)the time duration from the onset to admission. Thus meticulous attention and treatment are emphasized in the primary care for the children with spontaneous cerebellar himorrhage.
