Salazar J, Vaquero J, Martinez P, Santos H, Martinez R, Bravo G
Acta Neurochir (Wien). 1986;79(2-4):80-6. doi: 10.1007/BF01407449.
We have studied 15 cases of spontaneous intracerebellar haematomas in 9 males and 6 females. A significant correlation between the clinical presentation and the CT scan features of benign and fatal haemorrhages of the cerebellum is presented. Diagnostic computerized tomographic studies were performed in a mean interval of 31 hours after the initial symptoms. 60% were diagnosed and treated in less than 24 hours; 11 patients had haematomas larger than 3 cm, and 5 (45%) of these cases died with evidence of irreversible brain-stem damage. Twelve (80%) showed compression of the fourth ventricle, 9 (60%) obliteration of the brain-stem cisterns and 8 (53%) ventricular dilatation. 8 cases were treated with surgery; 50% of them showed neurological improvement, including two cases with signs of brain-stem compression. 7 patients who were treated conservatively were followed closely with repeated CT scans, which showed that resolution of the mass effect and isodensity of the haematomas larger than 3 cm (73%), hydrocephalus (45%) and intraventricular haemorrhage (40%). Smaller haematomas without CT scan evidence of obliteration of the brain-stem cisterns or hydrocephalus had a better outcome.
我们研究了15例自发性小脑出血病例，其中男性9例，女性6例。本文呈现了小脑良性和致命性出血的临床表现与CT扫描特征之间的显著相关性。在出现初始症状后的平均31小时进行了诊断性计算机断层扫描研究。60%的患者在24小时内得到诊断和治疗；11例患者血肿大于3厘米，其中5例（45%）因不可逆的脑干损伤死亡。12例（80%）显示第四脑室受压，9例（60%）脑干池闭塞，8例（53%）脑室扩张。8例接受了手术治疗；其中50%显示神经功能改善，包括2例有脑干受压体征的患者。对7例保守治疗的患者进行了多次CT扫描密切随访，结果显示大于3厘米的血肿（73%）、脑积水（45%）和脑室内出血（40%）的占位效应消退且密度均匀。没有CT扫描证据显示脑干池闭塞或脑积水的较小血肿预后较好。
