抄録
The diagnosis of vascular disease in cerebellar region become ease by the advance of neuroradiological diognostic methods. However, it must be difficult to differentiate between intracerebellar hematoma and intracerebellar infarction. Our cases were diagnosed with vertebral angiography (VAG), conrary ventriculography (CVG) and computerized tomography (CT). In operative findings, one is intracerebellar hematoma, the other is cerebellar hemispheric infarction. They were both survived by suboccipital craniectomy and removal of the hematoma. The authers report and discuss each clinical course, diagnostic method and treatment.
33 years old woman (Case 1) was admitted both with the symptoms of high intracranial pressure and the right cerebellar symptome. The space occupying lesion was suspected by right VAG. CT revealed high density area from the center of cerebellum to right cereebllar hemisphere. The diagnosis was intracerebellar hematoma in right cerebellar hemisphere. She was operated and her post-operative course was uneventful.
58 year old woman (Case 2) has been suffered from symptome of remarkable high intracranial pressure and disturbed consciousness. Burr hole opennings and ventricular drainage was performed emergently. CVG showed the obstruction of aqueduct and the dilatation of the supratentorial ventricular system. The left VAG showed avascular area in left posterior fossa. We found hemorrhagic infarction of left cerebellar hemisphere at the time of operation.
Pathohistological study has no tumor cell nor microangioma in these 2 cases. Finally, the former is diagnosed spontaneous intracerebellar hematoma, the latter is hemorrhagic infarction of left cerebellar hemisphere.
In near future, possibility of eary diagnosis and the advance of neuro-radiological methods, especially CT are expected improvement of mortality and morbility of these cerebellar vascular disease.
