Yoshida N, Kagawa M, Takeshita M, Kitamura K
No Shinkei Geka. 1986 May;14(6):725-31.
Fifty six patients with hypertensive cerebellar hemorrhage diagnosed by CT scan were hospitalized from November 1976 up to June 1984. The 35 male and 21 female patients ranged in age from 24 to 84 years, and 39 of them were operated on. The important factors related to prognosis of cerebellar hemorrhage were level of consciousness, size of hematoma on CT scan, and massive ventricular hemorrhage resulting in obstruction of the ventricular system. We classified the patient with cerebellar hemorrhage into 5 grades, according to the severity of these factors. Grade I indicates cerebellar signs without disturbance of consciousness and size of hematoma less than 25 mm measured by CT scan. Grade II indicates disturbance of consciousness (stupor), or progressive neurological deficits, and size of hematoma less than 50 mm without acute hydrocephalus. Grade III reveals disturbance of consciousness (stupor-semicoma), and size of hematoma less than 50 mm with acute hydrocephalus. Grade IV reveals severe disturbance of consciousness (semicoma), and size of hematoma less than 50 mm with massive ventricular hemorrhage. Grade V exhibits deep coma, and more than 50 mm diameter of hematoma. The prognosis of all of 9 patients in Grade I was good, Eleven out of 13 patients (85%) in Grade II and all of 9 patients in Grade III were alive. Fourteen out of 19 patients (74%) in Grade IV and all of 6 patients in Grade V expired in spite of operation. The patients of Grade I should be treated by conservative therapy. The patients of Grade II, Grade III, and Grade IV should be managed surgically. Surgical treatment for Grade V is not advisable.
1976年11月至1984年6月期间，56例经CT扫描确诊为高血压性小脑出血的患者入院治疗。其中男性35例，女性21例，年龄在24岁至84岁之间，39例接受了手术治疗。与小脑出血预后相关的重要因素包括意识水平、CT扫描显示的血肿大小以及导致脑室系统梗阻的大量脑室出血。我们根据这些因素的严重程度将小脑出血患者分为5级。I级表示有小脑体征但意识无障碍，CT扫描测量血肿大小小于25mm。II级表示意识障碍（昏睡）或进行性神经功能缺损，血肿大小小于50mm且无急性脑积水。III级表示意识障碍（昏睡至浅昏迷），血肿大小小于50mm伴有急性脑积水。IV级表示严重意识障碍（浅昏迷），血肿大小小于50mm伴有大量脑室出血。V级表示深昏迷，血肿直径大于50mm。I级的所有9例患者预后良好，II级的13例患者中有11例（85%）存活，III级的所有9例患者均存活。IV级的19例患者中有14例（74%）死亡，V级的所有6例患者尽管接受了手术仍死亡。I级患者应采用保守治疗。II级、III级和IV级患者应进行手术治疗。V级患者不建议进行手术治疗。
