[Surgical treatment of hypertensive cerebellar hemorrhage; stereotactic aspiration surgery vs suboccipital craniectomy]. 1991

M Uno, and F Shichijo, and H Hondo, and K Matsumoto
Department of Neurological Surgery, School of Medicine, University of Tokushima, Japan.

Patients with severe types of hypertensive cerebellar hemorrhage have been treated usually by suboccipital craniectomy and hematoma evacuation. However, since 1981, we have treated such patients with stereotactic aspiration surgery. The purpose of this study was to evaluate the prognosis of patients treated by stereotactic aspiration surgery for cerebellar hemorrhage in comparison with those who underwent suboccipital craniectomy. Between May 1976 and December 1989, 246 patients with hypertensive cerebellar hemorrhage were admitted to our university hospital and affiliated hospitals. The patients were classified into four categories according to the grading of hypertensive cerebellar hemorrhage proposed by Matsumoto in 1982; benign, moderate, severe, and fulminant. Then we decided the most appropriate therapy according to this grading. Fifty-nine patients (24.0%) underwent suboccipital craniectomy and 38 (15.4%) underwent stereotactic aspiration surgery. There was no significant difference in the postoperative outcome between suboccipital craniectomy and stereotactic aspiration surgery in the overall study. However prognosis of the fulminant type was significantly better with stereotactic aspiration surgery than with suboccipital craniectomy. Possible reasons for this include: 1) All patients of this type who underwent aspiration surgery had this procedure within 12 hours after the onset of cerebellar hemorrhage. 2) The hematoma volume of most patients of this type who had aspiration surgery was under 30ml. 3) The age of all patients of this type with aspiration surgery was under 70 years old. In conclusion, we suggest that aspiration surgery for hypertensive cerebellar hemorrhage is indicated for all patients with moderate, severe and fulminant types of hemorrhage.

UI MeSH Term Description Entries
D006973 Hypertension Persistently high systemic arterial BLOOD PRESSURE. Based on multiple readings (BLOOD PRESSURE DETERMINATION), hypertension is currently defined as when SYSTOLIC PRESSURE is consistently greater than 140 mm Hg or when DIASTOLIC PRESSURE is consistently 90 mm Hg or more. Blood Pressure, High,Blood Pressures, High,High Blood Pressure,High Blood Pressures
D009777 Occipital Bone Part of the back and base of the CRANIUM that encloses the FORAMEN MAGNUM. Basilar Bone,Basilar Bones,Bone, Basilar,Bone, Occipital,Bones, Basilar,Bones, Occipital,Occipital Bones
D002526 Cerebellar Diseases Diseases that affect the structure or function of the cerebellum. Cardinal manifestations of cerebellar dysfunction include dysmetria, GAIT ATAXIA, and MUSCLE HYPOTONIA. Cerebellar Dysfunction,Cerebellum Diseases,Cerebellar Disorders,Cerebellar Syndromes,Cerebellar Disease,Cerebellar Disorder,Cerebellar Dysfunctions,Cerebellar Syndrome,Cerebellum Disease,Disease, Cerebellar,Disease, Cerebellum,Disorder, Cerebellar,Dysfunction, Cerebellar,Syndrome, Cerebellar
D002543 Cerebral Hemorrhage Bleeding into one or both CEREBRAL HEMISPHERES including the BASAL GANGLIA and the CEREBRAL CORTEX. It is often associated with HYPERTENSION and CRANIOCEREBRAL TRAUMA. Brain Hemorrhage, Cerebral,Cerebral Parenchymal Hemorrhage,Hemorrhage, Cerebral,Intracerebral Hemorrhage,Hemorrhage, Cerebrum,Brain Hemorrhages, Cerebral,Cerebral Brain Hemorrhage,Cerebral Brain Hemorrhages,Cerebral Hemorrhages,Cerebral Parenchymal Hemorrhages,Cerebrum Hemorrhage,Cerebrum Hemorrhages,Hemorrhage, Cerebral Brain,Hemorrhage, Cerebral Parenchymal,Hemorrhage, Intracerebral,Hemorrhages, Cerebral,Hemorrhages, Cerebral Brain,Hemorrhages, Cerebral Parenchymal,Hemorrhages, Cerebrum,Hemorrhages, Intracerebral,Intracerebral Hemorrhages,Parenchymal Hemorrhage, Cerebral,Parenchymal Hemorrhages, Cerebral
D003399 Craniotomy Surgical incision into the cranium. Craniectomy,Craniectomies,Craniotomies
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013238 Stereotaxic Techniques Techniques used mostly during brain surgery which use a system of three-dimensional coordinates to locate the site to be operated on. Stereotactic Techniques,Stereotaxic Technics,Stereotactic Technique,Stereotaxic Technic,Stereotaxic Technique,Technic, Stereotaxic,Technics, Stereotaxic,Technique, Stereotactic,Technique, Stereotaxic,Techniques, Stereotactic,Techniques, Stereotaxic
D013396 Suction The removal of secretions, gas or fluid from hollow or tubular organs or cavities by means of a tube and a device that acts on negative pressure. Aspiration, Mechanical,Drainage, Suction,Aspirations, Mechanical,Drainages, Suction,Mechanical Aspiration,Mechanical Aspirations,Suction Drainage,Suction Drainages,Suctions

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