A novel simple measure correlates to the outcome in 57 patients with intracerebellar hematomas. Results of a retrospective analysis.

Background: The incidence of intracerebellar hemorrhages approaches 5-10% of all intracerebral hematomas. The clinical presentation varies from headaches and dizziness to rapid deterioration of consciousness to the point of coma in severe cases. In order to find some concrete criteria that could influence the prognosis of these patients, we performed this retrospective study.

Methods: We retrospectively analyzed the factors influencing the outcome of 57 patients with intracerebellar hematomas treated in our clinic in the last 7 years. The Glasgow Coma Scale (GCS) on admission, as well as other parameters as hypertension, diabetes mellitus, presence of malign tumors in the medical history, or the intake of anticoagulants were assessed as independent factors influencing the outcome of the patients. On the other hand, various computed tomography parameters on admission were also correlated with the clinical outcome such as, tight posterior fossa (TPF), volume of the hematoma, hydrocephalus, compression of the fourth ventricle, intraventricular bleeding, as well as the ratio of the maximal width of the hematoma in comparison to the width of the PF were taken into consideration.

Results: The results of the study showed that patients with poor GCS on admission had also a poor Glasgow Outcome Score. Interestingly there was a statistically significant correlation between the maximal width of the hematoma in comparison to the width of the PF and the outcome of the patients. It could be also shown that the patients with intraventricular hemorrhage, hydrocephalus, compression of the fourth ventricle over 50% of its maximal width and TPF, had a poor clinical outcome. Moreover, there was a statistically significant correlation of the volume of the hematoma and a poor clinical outcome.

Conclusions: We introduced as a new factor that is, the cerebellar hemorrhage/PF ratio and found out that the value >35% was associated to an unfavorable outcome.