• Sae-Yeon Won, Johannes Walter, Silvia Hernandez-Duran, Obada T Alhalabi, Bedjan Behmanesh, Joshua D Bernstock, Marcus Czabanka, Nazife Dinc, Daniel Dubinski, Charlotte Flüh, Thomas M Freiman, Anne S Grosch, Eva Herrmann, Young Sill Kang, Juergen Konczalla, Andreas Kramer, Felix Lehmann, Johannes Lemcke, Ruzanna Melkonian, Dorothee Mielke, Lukas Müller, Florian Ringel, Veit Rohde, Matthias Schneider, Christian Senft, Patrick Schuss, Merih Öznur Turgut, Michael Synowitz, Joana M Ullmann, Hartmut Vatter, Klaus Zweckberger, Fatma Kilinc, and Florian Gessler.
• Department of Neurosurgery, University Medicine Rostock, Rostock, Germany.
• Neurosurgery. 2023 May 1; 92 (5): 102110281021-1028.

BackgroundAs compared with supratentorial intracerebral hemorrhages (ICH), bleeds that occur within the cerebellum require special consideration given the nature of the posterior fossa.ObjectiveTo validate ICH and ICH grading scale (ICH-GS) scores in patients with cerebellar hemorrhage and examine the outcomes of patients managed surgically as compared with those who underwent conservative treatment.MethodsThis observational multicenter study included 475 patients with cerebellar hemorrhage from 9 different neurosurgical departments in Germany between 2005 and 2021. The prognostic accuracy of ICH and ICH-GS scores were calculated by the area under the curve of the receiver operating characteristic curves. Analyzed outcomes were the in-hospital mortality, mortality at 6 months, in-hospital outcome, and outcome at 6 months.ResultsOf 403 patients, 252 patients (62.5%) underwent surgical treatment and 151 patients (37.5%) conservative treatment. Both ICH and ICH-GS scores demonstrated good prognostic accuracy regarding both overall mortality and functional outcomes. In those patients presenting with severe cerebellar hemorrhages, ie, ICH score >3 and ICH-GS score >11, overall mortality was significantly lower in surgically treated patients. Mortality was significantly higher in those patients managed surgically who presented with ICH scores 3; in such patients, improved outcomes were noted when the hematoma was treated conservatively.ConclusionICH and ICH scores are useful tools for prediction of survival and outcome in patients with cerebellar ICH. Surgical management may be beneficial for those who present with severe cerebellar ICH as reflected by ICH scores >3, while conservative management seems reasonable in patients with lower ICH scores.Copyright © Congress of Neurological Surgeons 2022. All rights reserved.

16 keywords...

hide…