Virgós-Señor B, Nebra-Puertas A C, Villagrasa-Compaired J, Van Popta J
Servicio de Medicina Intensiva, Hospital Universitario Miguel Servet, Zaragoza, España.
Med Intensiva. 2006 Jan-Feb;30(1):1-5. doi: 10.1016/s0210-5691(06)74454-0.
Spontaneous cerebellar hematomas (CH) represent 5%-10% of intracranial hemorrhaging. We describe the existing cardiovascular risk factors, clinical presentation of CH and its relationship with mortality and the association between the treatment type (conservative medical or neurosurgical treatment) and the subsequent course of the patients.
Observational study of patients diagnosed of CH admitted over three years in an Intensive Care Unit of a level III Hospital.
Fifty-six consecutive patients diagnosed of CH. VARIABLES OF PRINCIPAL INTEREST: We studied the cardiovascular risk factors, presentation form (with Glasgow Coma Scale- GCS), hematoma size and site, and morbidity-mortality of the patients (with the Glasgow Outcome Scale--GOS).
Fisher's exact test, Chi squared, calculation of Spearman's coefficient between certain variables and logistic regression analysis were used. Hematoma size, GCS on admission and presence of hydrocephaly obtained statistical significance. Conservative medical treatment has greater mortality.
Patients with GCS < or = 8 and hematoma size > or = 3 cm benefit from surgical treatment. Initial GCS and vermian site are mortality predictor factors. There is no more morbidity due to surgical treatment.
自发性小脑血肿（CH）占颅内出血的5%-10%。我们描述了现有的心血管危险因素、CH的临床表现及其与死亡率的关系，以及治疗类型（保守药物治疗或神经外科治疗）与患者后续病程之间的关联。
对一家三级医院重症监护病房三年内收治的诊断为CH的患者进行观察性研究。
56例连续诊断为CH的患者。主要关注变量：我们研究了心血管危险因素、表现形式（采用格拉斯哥昏迷量表-GCS）、血肿大小和部位，以及患者的发病率和死亡率（采用格拉斯哥预后量表-GOS）。
采用Fisher精确检验、卡方检验、某些变量之间的Spearman系数计算以及逻辑回归分析。血肿大小、入院时的GCS和脑积水的存在具有统计学意义。保守药物治疗的死亡率更高。
格拉斯哥昏迷量表评分≤8分且血肿大小≥3 cm的患者从手术治疗中获益。初始格拉斯哥昏迷量表评分和蚓部部位是死亡率的预测因素。手术治疗不会增加更多的发病率。
