Traumatic cerebellar hematoma: A tertiary care experience of 23 conservatively managed cases

Abstract

Context: Traumatic cerebellar hematomas are rare in comparison to nontraumatic cerebellar hematomas. Aims: The aim of this study is to evaluate the prognostic factors and outcome determining factors with regard to conservatively managed isolated traumatic cerebellar hematoma. Settings and Design: Retrospective cohort study. Materials and Methods: A retrospective study of 23 patients of conservatively managed isolated posterior fossa hematoma, admitted between August 2018 and May 2020, was conducted in the Department of Neurosurgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi. Each of the patients was evaluated in terms of age, sex, mode of injury, clinical presentation, comorbidity, the severity of injury, best motor response, Glasgow Coma Scale (GCS) at admission, computed tomography findings, and Glasgow Outcome Scale at discharge/death. Statistical Analysis: Chi-square test and unpaired t -test were used. P < 0.05 was deemed statistically significant. Results: Mean volume of posterior fossa contusion was 8.9 ml. The cerebellar hemispheric (60.9%) location of hematoma was more common. Age at presentation ( P = 0.0086), best motor response ( P < 0.0001), severity of injury ( P = 0.0002), GCS at admission ( P < 0.0001), effacement of basal cistern ( P < 0.0001), fourth ventricular compression and intraventricular hemorrhage ( P = 0.0008), presence of hydrocephalus ( P = 0.0142), subarachnoid hemorrhage ( P = 0.0008), and volume of posterior fossa contusion ( P = 0.0002) were significantly associated with outcome of posterior fossa contusion. Conclusion: Traumatic cerebellar hematoma is rare. Conservatively managed cerebellar hematoma patients must be monitored closely for neurological and radiological status. Patients who show deterioration in neurological or radiological status require surgical intervention.

Factors associated with post traumatic hydrocephalus following decompressive craniectomy: A single-center experience

“…Traumatic cerebellar contusions and hematomas are relatively uncommon. [ 15 ] When they do occur, they become risk factors for developing hydrocephalus, often due to the compression of posterior fossa CSF structures. The posterior fossa is a small intracranial compartment compared to the anterior and middle cranial fossa,[ 3 ] which makes compression of the fourth ventricle or cerebral aqueduct an established risk.…”

Prognostic and morphological factors in pediatric cerebellar contusions

“…[ 17 , 18 ] Despite their relative rarity, cerebellar contusions are associated with substantial morbidity and mortality, with estimates of poor clinical outcomes ranging between 20% and 100%, with an average of 60%. [ 1 , 5 , 8 , 14 , 15 ] These injuries result in a myriad of long-term sequelae that have a significant impact on patients’ quality of life, including the resultant development of deficits in speech, attention, and fine motor movement. [ 15 ] Due to their relative rarity, the existing literature is limited on the factors predicting and influencing the clinical picture and long-term outcomes of patients sustaining cerebellar contusions.…”

“…[ 15 ] Due to their relative rarity, the existing literature is limited on the factors predicting and influencing the clinical picture and long-term outcomes of patients sustaining cerebellar contusions. [ 1 , 14 ] Previous studies have demonstrated that the best indicator of outcomes following cerebellar contusions is the patients’ Glasgow Coma Scale (GCS) scores on admission. Other prognostic factors include effacement of the basal cisterns, 4 th ventricular compression, intraventricular hemorrhage, the size and location of the contusion, concomitant subarachnoid hemorrhage (SAH), and the presence of associated cerebral injury.…”

Endoscopic Third Ventriculostomy for Obstructive Hydrocephalus Secondary to Delayed Intracerebellar Hematoma

“…During the last decade, minimally invasive surgery has gained wide acceptance and popularity due to its excellent outcome and clinical results. In neurosurgery, the endoscopic third ventriculostomy (ETV) is universally performed for the treatment of primary and secondary hydrocephalus and its indications are broader every day [1].…”

“…Traumatic cerebellar hematomas or hemorrhagic contusions are rare in comparison to nontraumatic causes and may present acutely or in a delayed fashion when they are referred to as delayed traumatic intracerebellar hematoma [1].…”