[Surgical treatment of cerebellar infarction: Five case studies].

BACKGROUND AND PURPOSE: Surgical management of cerebellar infarction remains controversial. What surgical procedure should be performed when a patient presents neurological deterioration? When is the right moment to operate? Different treatments were proposed including decompressive suboccipital craniotomy, external ventricular drainage, or endoscopic third ventriculostomy.

METHODS

We retrospectively reviewed five cases of cerebellar infarction treated with suboccipital craniotomy, excision of necrotic tissue, and duraplasty within a period of six months.

RESULTS

The five patients were evaluated with regard to presenting symptoms, Glasgow Coma Scale (GCS) before surgery, timing of surgery, computed tomographic scans and magnetic resonance imaging (MRI), neurological improvement, and outcome within a follow-up period of one year. Four patients made a good recovery, one patient died three days after surgery without neurological improvement.

CONCLUSION

These results suggest that decompressive suboccipital craniotomy may be an effective solution for good recovery if the patient is operated early, at the moment of the neurological deterioration.