15 cases of intracerebellar haematomas [11 spontaneous, 2 traumatic and 2 unclear] were presented. Hypertension was thought to be a main risk factor in 91% in 11 of the spontaneous cases. 11 cases were treated medically. They were usually conscious, scoring not less than 13 in GCS with subacute or chronic picture of illness and harbouring small haematomas below 3 cm in diameter situated almost always in the hemisphere and with no signs of ventricular dilation. Mortality in medically treated patients was 9% [1 case]. The remainder were discharged in good state, usually with no or only slight neurological deficit. Complete haematoma absorption took about 14 days. There were no signs of delayed hydrocephalus in subsequent CT scans. When the haematoma was large, more than 3 cm in diameter, located usually in the vermis or in the vermis and cerebellar hemisphere, sometimes with ventricular involvement, the clinical presentation was acute and required CT diagnosis and surgical evacuation without delay due to low and deteriorating conscious level. Postoperative mortality was 25%, but delayed mortality was 100%. Vertebral angiography was performed in all cases of spontaneous haemorrhage and was normal in 54%, revealed atheromatous changes in 36% and the signs of cerebellar haematoma in only 10%. Arteriovenous malformations were excluded from this study. The authors believe, that the benign course of intracerebellar haematomas is more frequent than it was considered previously and needs no surgical treatment in many cases.
The text is raising the question of teaching by Internet, which reached peculiar scale in Poland, without any deeply reflexion about positive and negative effects of its using. In the article authors emphasize difficulties connected with using remote control - education, beginning from through lack of competences of average teacher in the scope of preparing e - learning materials, through dishonesty and impunity of students/pupils, closing on the difficulties connected with financial base (rather lack financial base) in the most educational institutions.
The case described concerns the clinical diagnosis of a vascular focus in the distribution of the posterior cerebral and superior cerebellar arteries. Up to now both carotid and vertebral angiography were required. Nontraumatic CT and radionuclide studies have allowed demonstration of the etiology of the disease in the occipital and cerebellar region without further neuroradiology examinations with contrast. Clinical diagnosis by using neuroradiological methods in the detection of infarct in the region of the posterior cerebral and cerebellar artery is seldom observed. The case of a vascular focus in the distribution of the posterior cerebral and superior cerebellar arteries was diagnosed using the above methods.
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