Lee Tsung-Han, Huang Yu-Hua, Su Tsung-Ming, Chen Chih-Feng, Lu Cheng-Hsien, Lee Hsiang-Lin, Tsai Hui-Ping, Sung Wen-Wei, Kwan Aij-Lie
Division of Neurosurgery, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan.
Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan.
J Clin Med. 2019 Jun 8;8(6):818. doi: 10.3390/jcm8060818.
Spontaneous cerebellar hemorrhage (SCH) is associated with high patient mortality and morbidity, but the clinical and radiographic predictors of the postoperative outcome have not been widely addressed in the literature. The purpose of this study was to define the prognostic factors for the two-year postoperative outcome in patients with SCH. We conducted a retrospective study of 48 consecutive patients with SCH who underwent neurosurgical intervention. Correlation analysis was performed to examine the possible link between clinical and radiographic parameters, and the National Institutes of Health Stroke Scale (NIHSS) score at each patient's discharge and the two-year postoperative outcome as defined according to the Glasgow outcome scale (GOS). A total of 48 patients with SCH underwent neurological surgery, which included suboccipital craniectomy and/or external ventricular drainage (EVD). The mean patient age was 63 years. Nine patients underwent suboccipital craniectomy only; 38 underwent both suboccipital craniectomy and EVD. The overall mortality rate was 35.4%. Fourteen patients (29.2%) had good outcomes. A good outcome on the GOS at 2 years after surgical treatment of SCH was associated with the NIHSS score at discharge. An increase of one point in a patient's NIHSS score at discharge following neurological surgery will increase the probability of a poor two-year postoperative outcome by 28.5%.
自发性小脑出血(SCH)与患者的高死亡率和高发病率相关,但术后结果的临床和影像学预测因素在文献中尚未得到广泛探讨。本研究的目的是确定SCH患者术后两年结果的预后因素。我们对48例连续接受神经外科手术干预的SCH患者进行了一项回顾性研究。进行相关性分析以检验临床和影像学参数之间的可能联系,以及根据格拉斯哥预后量表(GOS)定义的每位患者出院时的美国国立卫生研究院卒中量表(NIHSS)评分与术后两年结果之间的关系。共有48例SCH患者接受了神经外科手术,包括枕下颅骨切除术和/或脑室外引流(EVD)。患者的平均年龄为63岁。9例患者仅接受了枕下颅骨切除术;38例患者同时接受了枕下颅骨切除术和EVD。总死亡率为35.4%。14例患者(29.2%)预后良好。SCH手术治疗后2年GOS预后良好与出院时的NIHSS评分相关。神经外科手术后患者出院时NIHSS评分每增加1分,术后两年预后不良的概率将增加28.5%。