Acute cerebellar hemorrhage. Analysis of clinical findings and outcome in 12 cases.

Although a majority of reported cases of cerebellar hemorrhage are subacute or chronic, an acute form of cerebellar hemorrhage occurs that results in coma within 48 hours of onset and is probably always fatal without surgical intervention. Our experience with 12 consecutive patients with proved acute cerebellar hemorrhage is summarized. Of three patients treated with aggressive medical therapy alone, none survived more than 48 hours. In seven of nine operated cases, emergency surgery was undertaken solely on the strength of clinical diagnosis without radiologic confirmation. Three died postoperatively. Of six survivors, two recovered fully, and two show mild and two moderate residua. The major factors influencing survival were the rate of evolution of signs and the level of consciousness at the moment of surgery.