Ng Z X, Yang W R, Seet E, Koh K M, Teo K J, Low S W, Chou N, Yeo T T, Venketasubramanian N
Division of Neurosurgery, Department of General Surgery, Khoo Teck Puat Hospital, 90 Yishun Central, Singapore 768828.
Singapore Med J. 2015 Mar;56(3):145-9. doi: 10.11622/smedj.2014195.
Cerebellar infarcts and haemorrhages are relatively uncommon, accounting for less than 10% of all strokes. The objective of the present study was to quantify and compare the outcomes of patients with cerebellar infarct and those of patients with cerebellar haemorrhage, as well as to identify the risk factors that predict poor outcome in patients with cerebellar stroke.
We retrospectively reviewed the medical records of consecutive patients admitted to National University Hospital, Singapore, between 2004 and 2006, within one week of cerebellar stroke onset. Baseline data included demographics, concomitant comorbidities, and the presence or absence of brainstem compression and hydrocephalus (on computed tomography or magnetic resonance imaging). The Glasgow Outcome Scale and modified Rankin Score were used to assess outcome at discharge and at six months after discharge.
A total of 79 patients with cerebellar stroke were admitted during the study period. Of these 79 patients, 17.7% died and 31.6% had poor outcomes at six months after discharge. Patients with cerebellar haemorrhage were found to be more likely to have poor outcomes as compared to patients with cerebellar infarct, both at discharge (odds ratio [OR] 4.3, 95% confidence interval [CI] 1.3-14.1) and at six months after discharge (OR 5.2, 95% CI 1.6-17.2). When compared to small lesions (< 5 cm(3)), lesions > 20 cm(3) were significantly associated with poorer outcomes and the development of hydrocephalus and brainstem compression.
Cerebellar strokes are a significant cause of morbidity and mortality. The outcomes of patients with cerebellar haemorrhage are more likely to be worse than those of patients with cerebellar infarct.
小脑梗死和出血相对少见，占所有中风的比例不到10%。本研究的目的是量化并比较小脑梗死患者和小脑出血患者的预后情况，以及确定预测小脑中风患者预后不良的危险因素。
我们回顾性分析了2004年至2006年间新加坡国立大学医院连续收治的小脑中风发病一周内患者的病历。基线数据包括人口统计学资料、合并症，以及是否存在脑干受压和脑积水（通过计算机断层扫描或磁共振成像）。采用格拉斯哥预后量表和改良Rankin量表评估出院时及出院后6个月的预后情况。
研究期间共收治79例小脑中风患者。在这79例患者中，17.7%死亡，31.6%在出院后6个月预后不良。与小脑梗死患者相比，小脑出血患者在出院时（优势比[OR]4.3，95%置信区间[CI]1.3 - 14.1）和出院后6个月（OR 5.2，95%CI 1.6 - 17.2）预后不良的可能性更大。与小病灶（<5 cm³）相比，病灶>20 cm³与更差的预后以及脑积水和脑干受压的发生显著相关。
小脑中风是发病和死亡的重要原因。小脑出血患者的预后比小脑梗死患者更可能更差。
