Cerebellar infarcts in the area of the supply of the PICA and their surgical treatment.

The authors report seven cases of cerebellar infarcts in the distribution of the PICA, of whom six were treated surgically. Only one patient died and he was not operated on. Although of the remaining six patients four were comatose, and two presented obvious signs of midbrain decerebration, all of them subsequently showed a really good quality of survival. In addition to the clinical details of the cases which are set out in tabular form, a survey of the literature is given and the indications for surgical treatment discussed. The exact interpretation of the CT scan and, in this context, particularly of the brain stem and its surrounding cisterns, above all the cisterns of the quadrigeminal plate and of the vein of Galen, gives decisive help in assessing the indications for suboccipital decompressive craniotomy. In view of the small number of cases, expressing the mortality rate in percentages would seem to be pointless. However, it appears appropriate to describe our experiences of the last two years and to recommend surgical treatment.