Surgical treatment of spontaneous cerebellar hematomas

Objective: To present the result of the urgent surgical treatment of spontaneous cerebellar hematoma.
Study Design: The data of 27 patients with spontaneous cerebellar hematoma were analyzed retrospectively, between January 1995 and October 2003. The patients were grouped according to computed tomography appereances and Glasgow> coma scale score. All cases were operated by suboccipital craniectomy. Volüme of hematomas and preoperative Glasgow coma scale scores were compared with postoperative neurologic status. Mean follow-up was 16 months (range 6 to 25 months).
Results: 17 patients (%63) were male and the remaining 10 (%27) female. The age of the cases was ranged 42-87. 7 patients who died had two or more general risk factors. Positive correlation was established between preoperative Glasgow> coma scale score and postoperative neurologic status (p=0.001). Voliime of hematoma which was more than 20 milliliter influnced the postoperative result negatively (p<0.01).
Conclusions: It was concluded that volume of hematoma and Glasgow coma scale score were the main determinant in the postoperative prognosis of these cases

Spontan serebeller hematomlarda cerrahi tedavi

Amaç: Spontan serebellar Kematom olgularýnda acil cerrahi tedavi sonuçlarýmýzý sunmaktýr.
Gereç ve Yöntem: Bu çalýþmada Ocak 1995 - Ekim 2003 tarihleri arasýnda Þiþli Etfal Hastanesi Nöroþirürji Kliniðine baþvuran ve spontan serebellar hematom tanýsý koyulup acil cerrahi uygulanan 27 hasta retrospektif olarak incelendi. Olgular bilgisayarlý tomografi görüntülerine ve Glasgow koma skorlarýna göre gruplandýrýldý. Olgularýn hepsi suboksipital kraýýiektomi yaklaþýmýyla öpere edildi. Olgularýn ameliyat sonrasý nörolojik muayeneleri ile hematom boyutlarý ve pre- op erat if Glasgow koma skorlarý istatistiksel olarak karþýlaþtý¬rýldý. Ortalama takip süresi 16 ay (6-25 ay) idi. Bulgular: Olgularýn 17’si (% 63) erkek. 10’u (%27) kadýn olup, yaþlarý 42 ile 87 arasýnda deðiþiyordu. Eksitus olan 7 olgunun hepsinde iki veya daha fazla risk faktörü mevcuttu. Ameliyat öncesi Glasgow koma skoru ile ameliyat sonrasý klinik tablo arasýnda pozitif yönde iliþki saptandý (p=0,001). Hematom hacminin 20 mililitrenin üzerinde olmasý da posto- peratif sonucu olumsuz etkiliyordu (p<0.001).
Sonuç: Spontan serebellar hematom ile baþvuran olgularda hematomun hacmi ve Glasgow koma skorunun ameliyat sonrasý progrýozda temel belirleyici etkenler olduðu görüldü.