Abstract
Eleven cases of traumatic intracerebellar hemorrhage caused by severe head injury were presented and examined for their neurological signs, associated computed tomography (CT) findings and their outcome. These cases were divided into two types. The first is an acute type, which showed intracerebellar hemorrhage on the initial CT, and the second is a delayed type, which showed a hemorrhage on a subsequent CT without any findings in the posterior fossa in the initial CT scanning. The state of consciousness on admission of these patients was 8 or less by the Glasgow Coma Scale except for one case. Signs of brain stem injury were frequently seen on admission, such as absence of oculocephalic reflex, respiratory disturbance, and conjugate deviation of the eyes. Cerebellar signs were not usually observed. Nine out of 11 patients died and the Glasgow Outcome Scales of the two surviving cases were severe disability and persistent vegetative state. Associated CT findings of supratentorial region were observed in all cases of the acute type and three cases (75%) of the delayed type. There was not much difference in the neurological signs and the associated CT findings between the acute type and the delayed type. These results suggest that a strong impact acted on a supratentorial region as well as on the posterior fossa. With the introduction of CT scan, it has become much easier to diagnose this pathology. These cases suggest that a prompt evacuation of the hematoma or decompression of the posterior fossa should be attempted to yield satisfactory clinical results.
