抄録
A series of 18 patients with hypertensive cerebellar hemorrhages diagnosed with computed tomography (CT) is described. The clinical course appeared to fall into three groups. Group I (56%) did not exhibit consciousness disturbances and improved spontaneously. Group II (22%) developed gradual deterioration of consciousness. Group III (22%) became comatose within 12 hours and developed signs of brain stem dysfunction. The CT findings reflected the three clinical groups. The CT of Group I revealed a small hematoma ( ≥24 mm) with or without ventricular hemorrhage. The scans of Group II demonstrated hematomas of moderate volume (34 ?? 52 mm) with a partial defect of the perimesencephalic cisterns. The CT of Group III showed a large hematoma ( ≥43 mm) with massive ventricular hemorrhaging and obstructive hydrocephalus. Severe mass effects on the brain stem were also seen.
The patients of Group I should be treated by conservative therapy and Group II by emergent suboccipital craniectomy and evacuation of the hematoma. Surgical indication for the patients in Group III could not be determined.
