Conservative management in a rare case of spontaneous bilateral cerebellar haemorrhage

Intracranial haemorrhage is usually associated with various risk factors such as hypertension, aneurysm, bleeding diatheses, anticoagulant use, amyloid angiopathy and remote bleed occurring after supratentorial and spinal surgery. Simultaneous bilateral cerebellar haemorrhage is rarely observed outside the setting of known precipitants and may follow a rapid downhill course. We present an unusual case of a young man who presented to us with sudden-onset cerebellar signs due to haemorrhage occurring in both the cerebellar hemispheres. Our patient had a favourable outcome with conservative management despite having bilateral cerebellar haematoma with partial obliteration of the fourth ventricle.