Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, No. 325, Sec. 2, Cheng-Kung Road, Neihu District, Taipei, Taiwan.
Cerebellum. 2010 Sep;9(3):259-63. doi: 10.1007/s12311-010-0181-x.
We report a case of cerebellar hemorrhage (CH) that recurred in other hemisphere after 4 months of the first attack. A 58-year-old man presented with general weakness and computerized tomography (CT) of the brain showed a 41 mm hematoma in the right cerebellum with intraventricular extension. The satisfactory outcome was obtained after emergency surgical intervention and intensive rehabilitation. However, the patient irregularly took the prescribed anti-hypertensive medication. Four months after first attack, the recurrent CH in left side showed by brain CT. Only 2 cases of recurrent CH have been published thus far. The patient is the third reported case of recurrent CH and the second case in which CH recurred in the other hemisphere. Further, no patient has been reported to develop recurrence of CH in such a short period after the first onset. We discuss the possible pathophysiology, clinical course, treatment outcome, risk factors associated with such events and the importance of blood pressure control for preventing recurrence.
我们报告了一例小脑出血(CH),在第一次发作后 4 个月,在对侧半球复发。一名 58 岁男性出现全身无力,脑部计算机断层扫描(CT)显示右侧小脑有 41 毫米血肿,伴有脑室延伸。紧急手术干预和强化康复后获得了满意的结果。然而,患者不规则地服用了规定的抗高血压药物。第一次发作后 4 个月,脑部 CT 显示左侧再次发生 CH。迄今为止,仅发表了 2 例复发性 CH。该患者是第 3 例复发性 CH 病例,也是第 2 例 CH 在对侧半球复发的病例。此外,没有患者报告在第一次发作后如此短的时间内发生 CH 的复发。我们讨论了可能的病理生理学、临床过程、治疗结果、与这些事件相关的危险因素以及控制血压对预防复发的重要性。