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Cerebellar Hemorrhage

Cerebellar hemorrhage occurs when bleeding takes place in the cerebellum, usually from a stroke. Cerebellar Hemorrhage result from the same causes as other intracerebral hemorrhages. Long-standing hypertension with degenerative changes in the vessel walls and subsequent rupture is believed to be the most common cause. Hemorrhage into tumor, blood dyscrasias, amyloid angiopathy, arteriovenous malformations, trauma, and sympathomimetic abuse are less common causes of Cerebellar Hemorrhage.

This is advances in neuroimaging have led to revision of treatment concepts for cerebellar hemorrhage (CH). In the pre–computed tomography (CT) era, patients with large hematomas (which were detected by angiography or at postmortem examination) were overrepresented in clinical series. Therefore, surgical therapy was stressed. The cerebellum is the part of the brain located on the lower backside of the skull (just above the neck). 

The cerebellum plays a major role in maintaining balance.  Cerebellar hemorrhage occurs when bleeding takes place in the cerebellum, usually from a stroke. We have reviewed the records of 22 patients with spontaneous cerebellar hemorrhage. One question that we considered was whether the increased recognition of this disorder, since the introduction of computed tomography (CT) scanning, had brought about a change in the associated signs and symptoms, as compared with previous series. No such change was found. Nine patients died, four after operation (ventricular shunting in one, clot evacuation in one, both procedures in two patients). The five other patients were considered inoperable, because they showed signs of compression of the caudal brainstem.

Cause of Cerebellar Hemorrhage

Some common are causes of Cerebellar Hemorrhage follows:

  • Hypertension - Suspected rupture of small penetrating vessels
  • Anticoagulant use
  • Blood dyscrasias
  • Arteriovenous malformation rupture
  • Sympathomimetic drug use
  • Hemorrhage into tumor
  • High Blood Pressure
  • Heavy alcohol consumption
  • Cocaine
  • Arteriovenous malformations
  • Brain Aneurysm
  • Blood thinners such as Coumadin

Symptoms of Cerebellar Hemorrhage

Some importent sympotoms of Cerebellar Hemorrhage follows :

  • Headaches in lower back of skull
  • Vomiting
  • Balance problems with walking
  • Dizziness
  • Vertigo ("spinning sensation")
  • Double vision
  • Closed eyelid
  • Rapid eye movements
  • Speaking difficulties
  • Swallowing difficulties

Treatment of Cerebellar Hemorrhage

There are most importent treatment of Cerebellar Hemorrhage:

  • Of elevated blood pressure -- cautiously -- once cerebellar hemorrhage has occurred (done in hospital by a physician)
  • Neurosurgical evaluation to consider removal of hemorrhage (blood clot) in brain
  • Mannitol or similar agent to lower the pressure in the brain
  • The most common cause is poorly controlled High Blood Pressure (hypertension).  It is important to take blood pressure medications as prescribed, and to have your blood pressure followed carefully by you and your physician.
  • Most investigators agree that a patient who is awake and has a Glasgow coma scale score of 14 or greater (some investigators say 9 or greater) with a small hemorrhage (some investigators say <30 mm, others <40 mm) without hydrocephalus may be a candidate for conservative supportive care with close monitoring.
  • Surgical care has been the mainstay of therapy for CH, although some patients with small hematomas may be treated successfully without surgery.

 


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