Association of surgical treatment with functional outcome in patients with spontaneous cerebellar hemorrhage

Abstract

Objective: To investigate the relation of surgical treatment with patient’s 180-day outcome. Subject and method: Thirty-six patients who suffered a first spontaneous cerebellar hemorrhage (SCH) were treated with operation from January 2017 to March 2022. This study aimed to identify potential clinical and computed tomography (CT) features influencing outcomes after 6 months from ictus, and the association of surgical treatment with SCH patients. Result: The mean age was 62.9 years (IQR 43–83 years). Hypertension was the most common underlying disease (31 patients, 86.1%), followed by smoking (15 patients, 41.7%). 63.9% (23/36) of patients showed loss of consciousness at the initial presentation. Among 36 patients, 25 patients (70%) underwent surgical hemorrhage evacuation with placement of an external ventricle drainage (EVD), 4 patients (10.4%) received an EVD only. The six-moth mortality rate was 33.33%, 12 patients (33.34%) had good outcome (modified Rankin Scale – mRS < 3). In multivariate analysis only the Glasgow coma scale (GCS) score and intracerebral hemorrhage (ICH) score on admission was significant predictor of six-month outcome ([odds ratio (OR) = 1.50, 95% confidence interval (CI): 1.08-2.08, p=0.01; OR = 0.32, CI: 0.10–1.05, p=0.03), respectively. Conclusion: Surgical treatment can be effective for selected patients without lower GSC scores on admission. However, a higher ICH score on admission was associated with a 180-day outcome in patients with SCH.