Conservative management in a rare case of spontaneous bilateral cerebellar haemorrhage

Lalla, Rakesh; Malhotra, Hardeep Singh; Garg, Ravindra Kumar; Verma, Rajesh

doi:10.1136/bcr-2012-006177

Cited by 3 publications

(4 citation statements)

References 18 publications

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“…The most common area of bilateral MSICHs was the bilateral basal ganglia (table 2 ) with 35 cases (33.33%); this was followed by bilateral thalamic hemorrhages, which were found in 19 cases (18.10%). The cerebellum was the most common location of hematomas in the infratentorial region, but bilateral cerebellar hemorrhages were found in only 1 case (0.95%), as reported recently in 2012 (table 2 ) [ 29 ].…”

Section: Resultssupporting

confidence: 52%

“…A total of 35 articles (table 1 ) are from Asian countries: 26 articles are from East Asia, with 17 from Japan [ 4 , 8 , 9 , 10 , 13 , 14 , 16 , 17 , 30 , 34 , 36 , 37 , 38 , 39 , 41 , 42 , 46 ], 6 from Korea [ 11 , 12 , 15 , 18 , 24 , 40 ] and 3 from Taiwan [ 19 , 32 , 35 ], and 9 articles are from other Asian countries, with 3 from India [ 20 , 23 , 29 ], 3 from Turkey [ 22 , 25 , 26 ], 2 from Iraq [ 28 , 31 ] and 1 from Nepal [ 27 ]. The remaining 9 articles are from outside Asia: 1 from Serbia in Europe [ 21 ], 6 from the USA [ 1 , 5 , 6 , 7 , 43 , 44 ], and 1 each from Cuba in the Caribbean [ 45 ] and Argentina in South America [ 33 ].…”

Section: Resultsmentioning

confidence: 99%

“…There was only 1 case of bilateral lobar hemorrhages, which were found in the bilateral occipital lobes; this case was reported in 1997 [ 13 ]. The only case of bilateral cerebellar hemorrhages was recently reported in 2012 [ 29 ]. Nonbilateral primary MSICHs were first reported in 1982; they were a combination of basal ganglia and thalamic hemorrhages [ 38 ].…”

Section: Discussionmentioning

confidence: 99%

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Primary Multiple Simultaneous Intracerebral Hemorrhages between 1950 and 2013: Analysis of Data on Age, Sex and Outcome

Laiwattana

Sangsawang

2014

Cerebrovasc Dis Extra

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Background: Primary multiple simultaneous intracerebral hemorrhages (MSICHs) are quite rare. Although occasional reports have been found, there have been no systematic reviews. The published case reports and case series contain overlapping data, leading to erroneous information about MSICHs. This is the first extensive review of accessible studies published in English on MSICHs. Our primary objective was to analyze the demographic data on age, sex, outcome and prognosis with regard to primary MSICHs. Summary: A PubMed search without language restriction for articles with results from human studies and registered between January 1950 and September 2013 yielded 677 articles. The following inclusion criteria were applied: (1) reported case(s) or case series on primary MSICHs; (2) text partly or fully in English, and (3) text contains identifiable data on age, sex and outcome of patients. A total of 24 articles met all the inclusion criteria. The reference lists of these 24 articles were inspected for additional relevant articles, which yielded another 20 articles. In all, 248 cases were identified; 143 cases were excluded for various reasons: 52 duplicate cases, 18 cases of multiple nonsimultaneous intracerebral hemorrhages, 25 cases of secondary MSICHs, and 48 cases with incomplete data on age, sex and outcome. The remaining 105 cases were analyzed. MSICHs were found to be more common in bilateral cases (53.33%): there were bilateral basal ganglia hemorrhages (33.33%), bilateral thalamic hemorrhages (18.10%), bilateral lobar hemorrhages (0.95%) and bilateral cerebellar hemorrhages (0.95%). Nonbilateral MSICHs were found in 46.67% of the cases. The hematomas were commonly distributed in the basal ganglia (45.83%), thalamus (30.56%) and cerebellum (10.19%). MSICHs were more frequently encountered in males (60.95%; average age: 59.13 ± 12.49 years). The average age of the female patients was higher (63.89 ± 13.11 years). Patients with primary MSICHs had a survival rate of 56.20%. There was a favorable outcome of primary MSICHs in 18.10% of all the cases, the highest proportion of which was in the nonbilateral MSICH group. The remaining 38.10% had unfavorable outcomes. Death occurred in 43.80% of all cases, the highest proportion being found in the bilateral basal ganglia hemorrhage group. Primary MSICHs share features with solitary intracerebral hemorrhage regarding age, sex, and the location and distribution of hematomas, but they have a poorer outcome (p < 0.05). Key Messages: Primary MSICHs are rare and share features with solitary intracerebral hemorrhage regarding age and the location and distribution of hematomas. Patients have a poorer prognosis but higher favorable outcome rates in case of survival. This information adds to the awareness of clinicians that higher rates of favorable outcomes can be achieved for MSICHs.

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Section: Resultssupporting

confidence: 52%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Primary Multiple Simultaneous Intracerebral Hemorrhages between 1950 and 2013: Analysis of Data on Age, Sex and Outcome

Laiwattana

Sangsawang

2014

Cerebrovasc Dis Extra

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“…Cerebellar hemorrhages related to arteriovenous malformations may often be missed upon autopsy examination because of the destruction of the malformation by thrombosis 5 ; however, in the presented case, the hemorrhagic/infarcted area of the cerebellum was extensively sampled. Spontaneous cerebellar hemorrhage, in the absence of trauma or any identifiable well-established risk factor, is an exceedingly rare occurrence; however, case reports in the literature describe such cases 2,9 …”

Section: Discussionmentioning

confidence: 99%