Management of Cerebellar Stroke: Factors Affecting Surgical and Non-Surgical Treatment

Tariq Muhammad, Nadeem Ahmad Memon

Abstract

Objective

To present the outcome and factors affecting both surgical and non-surgical decisions

in the management of cerebellar stroke.

Study design

Descriptive case series.

Place & Duration of study

Ziauddin University Hospital Clifton Campus Karachi, from January 2010 to June 2019.

Methodology

A group of selected patients with cerebellar hemorrhage and infarct were included in the study. At admission clinical status was recorded using Glasgow coma scale (GCS) score and outcome was measured using Glasgow outcome scale (GOS). The management was both conservative and surgical. The treatment was dependent on correlation of both clinical and radiological findings. No prophylactic intervention was carried out if there were disparity between clinical and radiological findings. Surgical intervention mostly included suboccipital decompressive craniectomy (SDC) with external ventricular drain (EVD). No duroplasty was performed. Follow up period was between 3 to 9 months.

Results

A total of 36 patients were included in the study. Only 41% patient required surgery and remaining were managed conservatively. Surgical intervention was predominantly in hematoma patients (66%) as compared to infarct (23%) patients. The Glasgow outcome scale (GOS) was largely between 4 to 5 with minimal disability. Mortality rate was 13.88% in both surgically and conservatively managed patients.

Conclusions

In a selected group of patients, surgical intervention is safe and lifesaving if performed timely. Equally good results are predictable with conservative management if instituted wisely.

Key words

Cerebellar hemorrhage, Cerebellar infarct, Decompressive craniectomy, External ventricular drain.