Abstract
The authors experienced two cases of cerebellar infarction with excellent recovery by surgical treatment. The first case was 30-year-old female. She was transfered to our clinic after 48 hours unconsciousness following embolectomy of abdominal aorta. On admission, she was deeply comatose and had no spontaneous respiration. Neurological examination revealed miotic and fixed pupils with loss of reaction to light. Cerebellar infarction was immediately diagnosed by left brachial angiography and CT scan. A bilateral suboccipital craniectomy was performed and necrotic left cerebellar hemisphere was resected. Five months later, she was discharged only with left cerebellar ataxia.
The second case was 33-year-old male. He had sudden onset of headache, vomiting and dysarthria.Three weeks later, he was admitted to our clinic. Neurological examination revealed bilateral papilledema, mild right hemiparesis and right cerebellar dysfunction. CT Scan revealed low density area at the right cerebellar hemisphere. Righ suboccipital craniectomy with biopsy was carried out. Postoperatively, neuro-logical deficits gradually recovered and normal daily activity was gained at the time of discharge.
We reviewed 34 cases in the literature and our 2 cases and classified these cases into 3 types from clinical point of view. Type I, with development of disturbance of consciousness or brain stem compression sign within 3 days. Type II, within 2 weeks and Type III, more than 2 weeks. No differential neurological deficit was found among 3 types. Operations were performed on 28 cases out of 36 cases. Nine cases were excellent, 12 were fair, 4 ware poor and 3 died. We proposed surgical decomoression as soon as possible when the diagnosis was properly made.
