Pollak L, Rabey J M, Gur R, Schiffer J
Department of Neurology, Assaf Harofeh Medical Center, Zerifin, Israel.
Clin Neurol Neurosurg. 1998 Jun;100(2):99-103. doi: 10.1016/s0303-8467(98)00015-8.
Few reports have compared patients operated for cerebellar infarcts with those operated for cerebellar hemorrhage. Considering our previous paper about patients with massive cerebellar infarcts, we report on our surgical experience with five patients with cerebellar hemorrhage. The indication for operation was decreased consciousness with signs of brainstem compression. In all patients hydrocephalus was absent or mild, as opposed to patients with cerebellar infarcts. Suboccipital craniotomy with hematoma evacuation was therefore the surgical procedure of choice. The outcome was worse than in patients with cerebellar infarcts. We conclude that depressed mental state in cerebellar hemorrhage is mainly due to pressure of the cerebellum on the activating reticular system of the brainstem. The surgical approach to patients with bleeding in the cerebellum differ somewhat from that of patients with cerebellar infarcts in timing and kind of first choice procedure.
很少有报告对接受小脑梗死手术的患者与接受小脑出血手术的患者进行比较。结合我们之前关于大面积小脑梗死患者的论文，我们报告了5例小脑出血患者的手术经验。手术指征为意识下降并伴有脑干受压体征。与小脑梗死患者不同，所有患者均无或仅有轻度脑积水。因此，枕下开颅血肿清除术是首选的手术方式。结果比小脑梗死患者更差。我们得出结论，小脑出血时精神状态低落主要是由于小脑对脑干激活网状系统的压迫。小脑出血患者的手术入路在时机和首选手术方式上与小脑梗死患者略有不同。
