[Clinicopathological analysis of fatal cerebellar hematomas]

An analysis is made of the clinical observations and pathological findings in 16 fatal cerebellar hematomas admitted at the Instituto de Neurología in Montevideo, over a period of 23 years. The absence of definitive lesions of the brainstem in the majority of cases, in spite of the rich symptomatology of brainstem disfunction (horizontal gaze palsies, vegetative syndrome decerebrate movements) is stressed, as well as the rapid evolution of those cases with intraventricular haemorrhage. Missed clinical diagnosis was also frequent in severely ill patients. Discussion is carried out around the importance of early diagnosis in the correct surgical management. Ventriculostomy alone, not followed by immediate craniectomy, may be highly dangerous. Mere evacuation of the cerebellar, and even of the ventricular clots can result insufficient if not followed by ventricular shunting in cases with ventricular inundation.