Traumatic intracerebellar hemorrhage: clinicoradiological analysis of 81 patients
We report 81 patients with a traumatic intracerebellar hemorrhagic contusion or hematoma managed between 1996 and 1998 at 13 Italian neurosurgical centers. Each center provided data about patients' clinicoradiological findings, management, and outcomes, which were retrospectively reviewed. A po...
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| Veröffentlicht in: | Neurosurgery 2002-01, Vol.50 (1), p.16-27 |
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| creator | d'Avella, Domenico Servadei, Franco Scerrati, Massimo Tomei, Giustino Brambilla, Gianluigi Angileri, Filippo F Massaro, Fulvio Cristofori, Luciano Tartara, Fulvio Pozzati, Eugenio Delfini, Roberto Tomasello, Francesco |
| description | We report 81 patients with a traumatic intracerebellar hemorrhagic contusion or hematoma managed between 1996 and 1998 at 13 Italian neurosurgical centers.
Each center provided data about patients' clinicoradiological findings, management, and outcomes, which were retrospectively reviewed.
A poor result occurred in 36 patients (44.4%). Forty-five patients (55.6%) had favorable results. For the purpose of data analysis, patients were divided into two groups according to their admission Glasgow Coma Scale (GCS) scores. In Group 1 (39/81 cases; GCS score, > or =8), the outcome was favorable in 95% of cases. In Group 2 (42/81 cases; GCS score, |
| doi_str_mv | 10.1097/00006123-200201000-00004 |
| format | Article |
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Each center provided data about patients' clinicoradiological findings, management, and outcomes, which were retrospectively reviewed.
A poor result occurred in 36 patients (44.4%). Forty-five patients (55.6%) had favorable results. For the purpose of data analysis, patients were divided into two groups according to their admission Glasgow Coma Scale (GCS) scores. In Group 1 (39/81 cases; GCS score, > or =8), the outcome was favorable in 95% of cases. In Group 2 (42/81 cases; GCS score, <8), the outcome was poor in 81% of cases. Twenty-seven patients underwent posterior fossa surgery. Factors correlating with outcome were GCS score, status of the basal cisterns and the fourth ventricle, associated supratentorial traumatic lesions, mechanism of injury, and intracerebellar clot size. Multivariate analysis showed significant independent prognostic effect only for GCS score (P = 0.000) and the concomitant presence of supratentorial lesions (P = 0.0035).
This study describes clinicoradiological findings and prognostic factors regarding traumatic cerebellar injury. A general consensus emerged from this analysis that a conservative approach can be considered a viable, safe treatment option for noncomatose patients with intracerebellar clots measuring less than or equal to 3 cm, except when associated with other extradural or subdural posterior fossa focal lesions. Also, a general consensus was reached that surgery should be recommended for all patients with clots larger than 3 cm. The pathogenesis, biomechanics, and optimal management criteria of these rare lesions are still unclear, and larger observational studies are necessary.</description><identifier>ISSN: 0148-396X</identifier><identifier>EISSN: 1524-4040</identifier><identifier>DOI: 10.1097/00006123-200201000-00004</identifier><identifier>PMID: 11844230</identifier><language>eng</language><publisher>United States</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Brain Concussion - diagnostic imaging ; Brain Concussion - surgery ; Brain Hemorrhage, Traumatic - diagnostic imaging ; Brain Hemorrhage, Traumatic - surgery ; Child ; Child, Preschool ; Female ; Glasgow Coma Scale ; Hematoma - diagnostic imaging ; Hematoma - surgery ; Humans ; Intracranial Embolism - diagnostic imaging ; Intracranial Embolism - surgery ; Italy ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Tomography, X-Ray Computed ; Treatment Outcome</subject><ispartof>Neurosurgery, 2002-01, Vol.50 (1), p.16-27</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c311t-8cfcddc2ac2d47acf15653f2e2fc5c8b8c764555358e365139dfd03cf81711653</citedby><cites>FETCH-LOGICAL-c311t-8cfcddc2ac2d47acf15653f2e2fc5c8b8c764555358e365139dfd03cf81711653</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11844230$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>d'Avella, Domenico</creatorcontrib><creatorcontrib>Servadei, Franco</creatorcontrib><creatorcontrib>Scerrati, Massimo</creatorcontrib><creatorcontrib>Tomei, Giustino</creatorcontrib><creatorcontrib>Brambilla, Gianluigi</creatorcontrib><creatorcontrib>Angileri, Filippo F</creatorcontrib><creatorcontrib>Massaro, Fulvio</creatorcontrib><creatorcontrib>Cristofori, Luciano</creatorcontrib><creatorcontrib>Tartara, Fulvio</creatorcontrib><creatorcontrib>Pozzati, Eugenio</creatorcontrib><creatorcontrib>Delfini, Roberto</creatorcontrib><creatorcontrib>Tomasello, Francesco</creatorcontrib><title>Traumatic intracerebellar hemorrhage: clinicoradiological analysis of 81 patients</title><title>Neurosurgery</title><addtitle>Neurosurgery</addtitle><description>We report 81 patients with a traumatic intracerebellar hemorrhagic contusion or hematoma managed between 1996 and 1998 at 13 Italian neurosurgical centers.
Each center provided data about patients' clinicoradiological findings, management, and outcomes, which were retrospectively reviewed.
A poor result occurred in 36 patients (44.4%). Forty-five patients (55.6%) had favorable results. For the purpose of data analysis, patients were divided into two groups according to their admission Glasgow Coma Scale (GCS) scores. In Group 1 (39/81 cases; GCS score, > or =8), the outcome was favorable in 95% of cases. In Group 2 (42/81 cases; GCS score, <8), the outcome was poor in 81% of cases. Twenty-seven patients underwent posterior fossa surgery. Factors correlating with outcome were GCS score, status of the basal cisterns and the fourth ventricle, associated supratentorial traumatic lesions, mechanism of injury, and intracerebellar clot size. Multivariate analysis showed significant independent prognostic effect only for GCS score (P = 0.000) and the concomitant presence of supratentorial lesions (P = 0.0035).
This study describes clinicoradiological findings and prognostic factors regarding traumatic cerebellar injury. A general consensus emerged from this analysis that a conservative approach can be considered a viable, safe treatment option for noncomatose patients with intracerebellar clots measuring less than or equal to 3 cm, except when associated with other extradural or subdural posterior fossa focal lesions. Also, a general consensus was reached that surgery should be recommended for all patients with clots larger than 3 cm. The pathogenesis, biomechanics, and optimal management criteria of these rare lesions are still unclear, and larger observational studies are necessary.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Brain Concussion - diagnostic imaging</subject><subject>Brain Concussion - surgery</subject><subject>Brain Hemorrhage, Traumatic - diagnostic imaging</subject><subject>Brain Hemorrhage, Traumatic - surgery</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Female</subject><subject>Glasgow Coma Scale</subject><subject>Hematoma - diagnostic imaging</subject><subject>Hematoma - surgery</subject><subject>Humans</subject><subject>Intracranial Embolism - diagnostic imaging</subject><subject>Intracranial Embolism - surgery</subject><subject>Italy</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Tomography, X-Ray Computed</subject><subject>Treatment Outcome</subject><issn>0148-396X</issn><issn>1524-4040</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2002</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkMtOwzAQRS0EoqXwC8grdgGPH4nDDlW8pEoIqUjsIndit0ZJXOxk0b8nhQKzGc3VvTOjQwgFdg2sLG7YWDlwkXHGOINxyvaSPCJTUFxmkkl2TKYMpM5Emb9PyFlKH4xBLgt9SiYAWkou2JS8LqMZWtN7pL7ro0Eb7co2jYl0Y9sQ48as7S3FxnceQzS1D01YezQNNZ1pdsknGhzVQLfjEtv16ZycONMke3HoM_L2cL-cP2WLl8fn-d0iQwHQZxod1jVyg7yWhUEHKlfCccsdKtQrjUUulVJCaStyBaKsXc0EOg0FwGidkaufvdsYPgeb-qr1CfevdzYMqSpAqkKU5WjUP0aMIaVoXbWNvjVxVwGr9jirX5zVH85vSY7Ry8ONYdXa-j944Ce-AHu8cOU</recordid><startdate>200201</startdate><enddate>200201</enddate><creator>d'Avella, Domenico</creator><creator>Servadei, Franco</creator><creator>Scerrati, Massimo</creator><creator>Tomei, Giustino</creator><creator>Brambilla, Gianluigi</creator><creator>Angileri, Filippo F</creator><creator>Massaro, Fulvio</creator><creator>Cristofori, Luciano</creator><creator>Tartara, Fulvio</creator><creator>Pozzati, Eugenio</creator><creator>Delfini, Roberto</creator><creator>Tomasello, Francesco</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200201</creationdate><title>Traumatic intracerebellar hemorrhage: clinicoradiological analysis of 81 patients</title><author>d'Avella, Domenico ; Servadei, Franco ; Scerrati, Massimo ; Tomei, Giustino ; Brambilla, Gianluigi ; Angileri, Filippo F ; Massaro, Fulvio ; Cristofori, Luciano ; Tartara, Fulvio ; Pozzati, Eugenio ; Delfini, Roberto ; Tomasello, Francesco</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c311t-8cfcddc2ac2d47acf15653f2e2fc5c8b8c764555358e365139dfd03cf81711653</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2002</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Brain Concussion - diagnostic imaging</topic><topic>Brain Concussion - surgery</topic><topic>Brain Hemorrhage, Traumatic - diagnostic imaging</topic><topic>Brain Hemorrhage, Traumatic - surgery</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Female</topic><topic>Glasgow Coma Scale</topic><topic>Hematoma - diagnostic imaging</topic><topic>Hematoma - surgery</topic><topic>Humans</topic><topic>Intracranial Embolism - diagnostic imaging</topic><topic>Intracranial Embolism - surgery</topic><topic>Italy</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>Tomography, X-Ray Computed</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>d'Avella, Domenico</creatorcontrib><creatorcontrib>Servadei, Franco</creatorcontrib><creatorcontrib>Scerrati, Massimo</creatorcontrib><creatorcontrib>Tomei, Giustino</creatorcontrib><creatorcontrib>Brambilla, Gianluigi</creatorcontrib><creatorcontrib>Angileri, Filippo F</creatorcontrib><creatorcontrib>Massaro, Fulvio</creatorcontrib><creatorcontrib>Cristofori, Luciano</creatorcontrib><creatorcontrib>Tartara, Fulvio</creatorcontrib><creatorcontrib>Pozzati, Eugenio</creatorcontrib><creatorcontrib>Delfini, Roberto</creatorcontrib><creatorcontrib>Tomasello, Francesco</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Neurosurgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>d'Avella, Domenico</au><au>Servadei, Franco</au><au>Scerrati, Massimo</au><au>Tomei, Giustino</au><au>Brambilla, Gianluigi</au><au>Angileri, Filippo F</au><au>Massaro, Fulvio</au><au>Cristofori, Luciano</au><au>Tartara, Fulvio</au><au>Pozzati, Eugenio</au><au>Delfini, Roberto</au><au>Tomasello, Francesco</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Traumatic intracerebellar hemorrhage: clinicoradiological analysis of 81 patients</atitle><jtitle>Neurosurgery</jtitle><addtitle>Neurosurgery</addtitle><date>2002-01</date><risdate>2002</risdate><volume>50</volume><issue>1</issue><spage>16</spage><epage>27</epage><pages>16-27</pages><issn>0148-396X</issn><eissn>1524-4040</eissn><abstract>We report 81 patients with a traumatic intracerebellar hemorrhagic contusion or hematoma managed between 1996 and 1998 at 13 Italian neurosurgical centers.
Each center provided data about patients' clinicoradiological findings, management, and outcomes, which were retrospectively reviewed.
A poor result occurred in 36 patients (44.4%). Forty-five patients (55.6%) had favorable results. For the purpose of data analysis, patients were divided into two groups according to their admission Glasgow Coma Scale (GCS) scores. In Group 1 (39/81 cases; GCS score, > or =8), the outcome was favorable in 95% of cases. In Group 2 (42/81 cases; GCS score, <8), the outcome was poor in 81% of cases. Twenty-seven patients underwent posterior fossa surgery. Factors correlating with outcome were GCS score, status of the basal cisterns and the fourth ventricle, associated supratentorial traumatic lesions, mechanism of injury, and intracerebellar clot size. Multivariate analysis showed significant independent prognostic effect only for GCS score (P = 0.000) and the concomitant presence of supratentorial lesions (P = 0.0035).
This study describes clinicoradiological findings and prognostic factors regarding traumatic cerebellar injury. A general consensus emerged from this analysis that a conservative approach can be considered a viable, safe treatment option for noncomatose patients with intracerebellar clots measuring less than or equal to 3 cm, except when associated with other extradural or subdural posterior fossa focal lesions. Also, a general consensus was reached that surgery should be recommended for all patients with clots larger than 3 cm. The pathogenesis, biomechanics, and optimal management criteria of these rare lesions are still unclear, and larger observational studies are necessary.</abstract><cop>United States</cop><pmid>11844230</pmid><doi>10.1097/00006123-200201000-00004</doi><tpages>12</tpages></addata></record> |
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| subjects | Adolescent Adult Aged Aged, 80 and over Brain Concussion - diagnostic imaging Brain Concussion - surgery Brain Hemorrhage, Traumatic - diagnostic imaging Brain Hemorrhage, Traumatic - surgery Child Child, Preschool Female Glasgow Coma Scale Hematoma - diagnostic imaging Hematoma - surgery Humans Intracranial Embolism - diagnostic imaging Intracranial Embolism - surgery Italy Male Middle Aged Prognosis Retrospective Studies Tomography, X-Ray Computed Treatment Outcome |
| title | Traumatic intracerebellar hemorrhage: clinicoradiological analysis of 81 patients |
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