Datar Sudhir, Rabinstein Alejandro A
Department of Neurology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Department of Neurology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Neurol Clin. 2014 Nov;32(4):993-1007. doi: 10.1016/j.ncl.2014.07.006. Epub 2014 Sep 11.
The clinical presentation of cerebellar hemorrhage can range from symptoms mimicking ischemic stroke to catastrophic neurologic decline. Symptomatology largely depends on the size of the hemorrhage and the degree of perilesional edema. The posterior fossa is a tight compartment with virtually no additional space to accommodate the mass effect. Thus, the hematoma and its associated swelling can cause obstructive hydrocephalus and brainstem compression, in severe cases contributing to early mortality, but outcome can be good if surgical intervention is appropriately timed. This article summarizes the current multidisciplinary approach to cerebellar hemorrhage, and addresses the controversies regarding its optimal management.
小脑出血的临床表现范围广泛,从类似缺血性卒中的症状到灾难性的神经功能衰退。症状学很大程度上取决于出血的大小和病灶周围水肿的程度。后颅窝是一个狭小的腔隙,几乎没有额外空间来容纳占位效应。因此,血肿及其相关的肿胀可导致梗阻性脑积水和脑干受压,严重时可导致早期死亡,但如果手术干预时机恰当,预后可能良好。本文总结了目前针对小脑出血的多学科治疗方法,并探讨了其最佳治疗方面的争议。