Surgical Management of Acute Cerebellar Infarction

Choi, Won Seok; Chung, Yong Gu; Kang, Shin Hyuk; Lee, Hoon Kap

Abstract

OBJECTIVE
The aim of this study is to determine which patients with progressively deteriorating acute cerebellar infarction would benefit from surgical treatment and which surgical procedure would best benefit them.
METHODS
Seventy six patients were treated at our hospital for cerebellar infarction over the past 3 years. Sixty nine patients received conservative management in the neurological department of our hospital. Among them, 7 patients (5 males and 2 females; average age, 49 yrs) were referred to neurosurgical department because of mental deterioration and underwent emergency surgery. Five patients underwent external ventricular drainage with suboccipital craniectomy and two patients underwent suboccipital craniectomy alone.
RESULTS
Of the 7 surgically treated patients, 4 patients experienced good recovery and 2 patients experienced moderate disability (disabled but independent) and 1 patient experienced severe disability (conscious but disabled). There was no death.
CONCLUSION
In patients conservatively treated for cerebellar infarction and showing mental deterioration and radiologically evident brainstem compression and ventricular enlargement, we strongly recommend suboccipital craniectomy (plus optional external ventricular drainage in case of showing hydrocephalus) as a first treatment option.