Infarctions Simulating Brain Tumours in the Posterior Fossa

Lindgren, S.

doi:10.3171/jns.1956.13.6.0575

Cited by 69 publications

(18 citation statements)

References 7 publications

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“…Since the first reports of decompressive surgery performed by Fairburn and Oliver 8 and by Lindgren,20 both in 1956, the potential value of suboccipital craniectomy and resection of necrotic tissue in cerebellar infarction has been recognized. However, cerebellar hemorrhage and infarction are distinct entities, which calls into question whether the same management principles should apply to each.…”

Section: Hemorrhagic Versus Ischemic Cerebellar Strokementioning

confidence: 99%

Controversies in the neurosurgical management of cerebellar hemorrhage and infarction

Amar

2012

FOC

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Evidence-based guidelines for the management of hemorrhagic and ischemic cerebellar stroke are sparse, and most available data come from Class III studies. As a result, opinions and practices regarding the nature and role of neurosurgical intervention vary widely. A comprehensive literature review was conducted to adjudicate several contentious issues, such as the difference in the management of cerebellar hemorrhage versus infarction, criteria for imaging to exclude an underlying structural lesion, the value of MRI for patient selection, the role of external ventricular drainage, the indications for operative management, the timing of surgical intervention, and various options of surgical technique, among others. Treatment algorithms proposed in several different studies are compared and contrasted. This analysis is concluded by a summary of the recommendations from the American Stroke Association, which advises that patients with cerebellar hemorrhage who experience neurological deterioration or who have brainstem compression and/or hydrocephalus due to ventricular obstruction should undergo surgical evacuation of the hemorrhage as soon as possible, and that initial treatment of such patients with ventricular drainage alone rather than surgical removal of the hemorrhage is not recommended.

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Section: Hemorrhagic Versus Ischemic Cerebellar Strokementioning

confidence: 99%

Controversies in the neurosurgical management of cerebellar hemorrhage and infarction

Amar

2012

FOC

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“…One of the four patients died of pulmonary embolism. 29 One of the three survivors made a complete recovery from the intracranial lesion but died from coronary thrombosis four months after the operation.…”

Section: Surgical Decompression For Cerebral Infarctsmentioning

confidence: 99%

Surgical Decompression for Cerebral and Cerebellar Infarcts

Ivamoto

Numoto

Donaghy

1974

Stroke

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“…80 The first case reports of surgical treatment by craniectomy were published independently but almost simultaneously in 1956 by Fairburn and Olivier 26 and Lindgren. 73 As of the writing of this study, 115 original papers on space-occupying cerebellar stroke including a total of over 750 patients have been published (see Table 3). …”

Section: Neurosurg Focus 34 (5):e8 2013mentioning

confidence: 99%

Space-occupying cerebellar infarction: complications, treatment, and outcome

Neugebauer

Witsch

Zweckberger

et al. 2013

FOC

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Space-occupying brain edema is a frequent and one of the most dreaded complications in ischemic cerebellar stroke. Because the tight posterior fossa provides little compensating space, any space-occupying lesion can lead to life-threatening complications through brainstem compression or compression of the fourth ventricle and subsequent hydrocephalus, both of which may portend transtentorial/transforaminal herniation. Patients with large cerebellar infarcts should be treated and monitored very early on in an experienced stroke unit or (neuro)intensive care unit. The general treatment of ischemic cerebellar infarction does not differ from that of supratentorial ischemic strokes. Treatment strategies for space-occupying edema include pharmacological antiedema and intracranial pressure–lowering therapies, ventricular drainage by means of an extraventricular drain, and suboccipital decompressive surgery, with or without resection of necrotic tissue. Timely escalation of treatment is crucial and should be guided by clinical and neuroradiological rationales. Patients in a coma after hydrocephalus and/or local brainstem compression may also benefit from more aggressive surgical treatment, as long as the conditions are reversible. Contrary to the general belief that outcome in survivors of space-occupying cerebellar stroke is usually good, recent studies suggest that for many of these patients, the long-term outcome is not good. In particular, advanced age and additional brainstem infarction seem to be predictors for poor outcome. Further trials are necessary to investigate these findings systematically and provide better selection criteria to help guide decisions about surgical therapies, which should always be carried out in close cooperation among neurointensive care physicians, neurologists, and neurosurgeons.

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Infarctions Simulating Brain Tumours in the Posterior Fossa

Cited by 69 publications

References 7 publications

Controversies in the neurosurgical management of cerebellar hemorrhage and infarction

Controversies in the neurosurgical management of cerebellar hemorrhage and infarction

Surgical Decompression for Cerebral and Cerebellar Infarcts

Space-occupying cerebellar infarction: complications, treatment, and outcome

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