Management of 171 cases of spontaneous cerebellar hemorrhage at a single department

Abstract

Objective: Spontaneous cerebellar hemorrhage (SCH) is associated with high mortality rates. However, in some cases, the prognosis is good after a quick and appropriate treatment. Although prognostic factors of SCH have been discussed in detail in the previous reports, these studies differed in population, design, and outcomes. Our institution is the only tertiary level institution in the district, with a population of 430,000 residents; thus, all the cases of severe intracerebral hemorrhage are treated at our institution. This study aimed to investigate the prognostic factors of SCH at our institution and to assess the treatment status for SCH in the district. Methods: We retrospectively evaluated SCH cases treated at our institution between January 2005 and June 2016. The patients with a modified Rankin Scale (mRS) of ≤2 before the SCH occurrence (171 cases) were investigated. Result: The average age of patients was relatively high (72.2±10.6 years). While mRS ≤3 was achieved in 54.4% of patients, mRS ≤2 was achieved in only 18.7% of patients. Among patients with fourth ventricle occlusion or disappearance of basal cisterns, surgery significantly improved their outcome. Older patients tended to have a higher risk of complications, which significantly influenced their outcomes. Conclusion: For SCH management, the initial treatment, including surgery, is important. Furthermore, because elderly people are at a high risk of complications, the management of complications is also very important, particularly, in an aging society such as that in our district.