SURGICAL-MANAGEMENT OF ACUTE CEREBELLAR INFARCTION

After reviewing the literature, a personal series of 10 adult patients with cerebellar infarction diagnosed by CT [computed tomography] scan is described. The clinical picture in young adult men is characterized by rapid onset of headache, vomiting, vertigo, ataxia and blurred vision. After this sudden onset the patients may present a stable course or a rapid or delayed onset of brain stem compression, revealed by impairment of consciousness. CT scan is the diagnostic method of choice. The correlation between angiographic and CT localization of the infarction is not good. In alert and clinically stable patients, medical treatment (mannitol, glycerol, dexamethasone). ICP [intracranial pressure] and serial CT monitoring are suggested. In alert patients with hydrocephalus or mass effect, medical treatment and monitoring as mentioned before, ventricular drainage if ICP surpasses 350 mm H2O2 should be done. In patients with impaired consciousness and hydrocephalus or mass effect, immediate ventricular drainage is suggested. If it is not followed by prompt improvement of the level of consciousness, an emergency suboccipital craniectomy with removal of the infarcted tissue should be done.