Advertisement

Surgical Aspects in Treatment of Cerebellar Infarction

  • R. Laumer
  • F. Erbguth
  • P. Nomikos
Conference paper
Part of the Advances in Neurosurgery book series (NEURO, volume 22)

Abstract

Supratentorial cerebral infarction is usually treated medically, but in some cases ventricular drainage is necessary. Regarding infratentorial cerebellar infarction a more aggressive treatment including decompression of the posterior fossa is currently under discussion. There have been a number of case reports suggesting surgical decompression as the treatment of choice in cerebellar infarction [1, 3, 5, 6]. The advantage of early operative treatment was first described in the 1950s [4, 8]; however, recent investigations seem to overestimate the benefit of aggressive therapy, based on isolated case reports with lack of new information. The main problem in evaluating the benefit of surgical decompression arises primarily from patient selection and timing of the surgical procedure. The case reports presented here demonstrate that so far there is no standard therapy for optimal treatment of cerebellar infarction. Outcome was assessed in terms of the modified Rankin scale [9] (the original Rankin scale did not include grades 0 and 6):
  1. Grade 0:

    No symptoms at all

     
  2. Grade 1:

    No significant disability despite symptoms: able to carry out usual duties and activities

     
  3. Grade 2:

    Slight disability: unable to carry out all previous activities but able to look after own affairs without assistance

     
  4. Grade 3:

    Moderate disability: requiring some help but able to walk without assistance

     
  5. Grade 4:

    Moderately severe disability: unable to walk without assistance and unable to attend to own bodily needs without assistance

     
  6. Grade 5:

    Severe disability: bedridden, incontinent, and requiring constant nursing care and attention

     
  7. Grade 6:

    Died

     

Keywords

Posterior Fossa Surgical Decompression Ventricular Drainage Cranial Compute Tomography Isolate Case Report 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Amarenco P, Hauw JJ (1990) Cerebellar infarction in the territory of the anterior and inferior cerebellar artery. A clinopathological study in 20 cases. Brain 113 (1): 139–155PubMedCrossRefGoogle Scholar
  2. 2.
    Bertalaffny H, de Vries J (1992) Management of cerebellar infarction with associated occlusive hydrocephalus. Clin Neurol Neurosurg 94 (1): 19–23CrossRefGoogle Scholar
  3. 3.
    Chen HJ, Lee TC, Wei CP (1992) Treatment of cerebellar infarction by decompressive suboccipital craniectomy. Stroke 23 (7):957–961PubMedCrossRefGoogle Scholar
  4. 4.
    Fairburn B, Oliver LC (1956) Cerebellar softening. A surgical emergency. Br Med J 1:1335–1336PubMedCrossRefGoogle Scholar
  5. 5.
    Heros RC (1992) Surgical treatment of cerebellar infarction. Stroke 23 (7):937–938PubMedCrossRefGoogle Scholar
  6. 6.
    Kase CS, Norring B, Levine SR et al. (1993) Cerebellar infarction. Clinical and anatomic observations in 66 cases. Stroke 24 (1):76–83PubMedCrossRefGoogle Scholar
  7. 7.
    Krieger D, Busse O, Schramm J, Febert A (1992) German-Austrian Space Occupying Cerebellar Infarction Study (GASCIS): study, design, methods, patient characteristics. The steering and Protocol Commission. J Neurol 239 (4): 183–185PubMedCrossRefGoogle Scholar
  8. 8.
    Lindgren SO (1956) Infarctions simulating brain tumours in the posterior fossa. J Neurosurg 13:575–581PubMedCrossRefGoogle Scholar
  9. 9.
    Van Swieten et al. (1988) Assessment of handicap after stroke. Stroke 603–608Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1994

Authors and Affiliations

  • R. Laumer
    • 1
  • F. Erbguth
    • 2
  • P. Nomikos
    • 1
  1. 1.Neurochirurgische KlinikUniversität Erlangen-NürnbergErlangenGermany
  2. 2.Neurologische KlinikUniversität Erlangen-NürnbergErlangenGermany

Personalised recommendations