Surgical treatment of cerebellar infarction.

Heros, Roberto C.

doi:10.1161/01.str.23.7.937

Cited by 110 publications

(57 citation statements)

References 14 publications

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“…On this basis, it is natural to question whether patients who remain dependent after surgery would have fared better if intervention had been performed earlier in their course. 12,19 For these reasons, many recommend surgery prior to clinical deterioration. 12 Yoshida et al 34 emphasize the importance of surgical therapy even for alert patients if the hematoma is larger than 3 cm to avoid delayed deterioration.…”

Section: Timing Of Surgical Interventionmentioning

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: Timing Of Surgical Interventionmentioning

confidence: 99%

Controversies in the neurosurgical management of cerebellar hemorrhage and infarction

Amar

2012

FOC

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“…(13,22,27) For traumatic cerebellar infarction, surgical intervention is the mainstay of treatment. (13,14,18,29) Without surgical intervention prognosis of these patients remain poor.…”

Section: Resultsmentioning

confidence: 99%

“…diversion of CSF (external ventricular drain) to control hydrocephalus and/or decompression of the posterior fossa to reduce the mass effect on brain stem. (1,5,13,14,17,22) Many authors advocate that surgical decompression should be performed first to reduce the mass effect and if the clinical features continue to persist or there is deterioration in neurological status a CSF diversion procedure can be performed. (5,11,(23)(24)(25)(26)(27) Management of the hydrocephalus with external ventricular drainage alone without posterior fossa decompression will not help to reduce the mass effect from the brain stem and shall be carrying the inherent risk of upward herniation.…”

Section: Case Reportmentioning

confidence: 99%

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Post-traumatic cerebellar infarction due to vertebral artery foramina fracture: case report

Moscote-Salazar¹,

Rubiano²,

Calderón-Miranda³

et al. 2016

Romanian Neurosurgery

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Posttraumatic cerebral infarction is an uncommon cause of morbidity and mortality and many studies have highlighted that trauma needs to considered as causative factor for cerebellar infarction. We present a case of cerebellar infarction in a 35 year old young patient secondary to vertebral fracture involving the vertebral foramen and vertebral artery injury. CT scan cervical spine showed C2-3 fracture on left side with fracture extending into the left vertebral foramen. A CT scan angiogram could not be performed because of poor neurological status. Possibly the infarction was due to left vertebral artery injury. Without surgical intervention prognosis of these patients remain poor. Prognosis of patients with traumatic cerebellar infarction depends on the neurological status of the patient, intrinsic parenchymal damage and more importantly extrinsic compression of the brainstem by the edematous cerebellar hemispheres.

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“…This mortality is due to the development of occlusive hydrocephalus or direct brainstem compression. In these patients, decompressive surgery of the posterior fossa is significantly superior to ventriculostomy 151,152 . It should be noted that these are the results of open small-or medium-sized case series, so data from a controlled, randomized trial are needed.…”

Section: Cerebellar Infarctionmentioning

confidence: 99%