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Long-Term Outcomes in Patients With Spontaneous Cerebellar Hemorrhage: An International Cohort Study

Jasper R Senff1,2,3,4,5, Sanjula D Singh1,2,6,3,4,5, Marco Pasi6,7,8

  • 1Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, the Netherlands (J.R.S., S.D.S., J.P.J.D., J.T., G.J.E.R., H.B.B.).

Stroke
|March 15, 2024
PubMed

Insights

Patients surviving a first cerebellar hemorrhage face a poor long-term prognosis and high risk of recurrent vascular events, similar to supratentorial hemorrhage survivors.

Area of Science:

  • Neurology
  • Cardiovascular Research
  • Public Health

Background:

  • Spontaneous intracerebral hemorrhage (ICH) in the cerebellum is associated with poor short-term outcomes.
  • Limited data exists on the long-term case fatality and recurrence of vascular events following cerebellar ICH.
  • Understanding long-term risks is crucial for patient management and secondary prevention strategies.

Purpose of the Study:

  • To assess the long-term case fatality rate after a first spontaneous cerebellar ICH.
  • To determine the recurrence rate of vascular events in patients who survive an initial cerebellar ICH.
  • To provide insights into the long-term prognosis and secondary prevention needs for cerebellar ICH survivors.

Main Methods:

  • International cohort study including 405 patients from 10 hospitals (1997-2017).
  • Patients aged ≥18 years with a first spontaneous cerebellar ICH, discharged alive, were included.
  • Data collected on long-term case fatality and recurrent vascular events (ICH, ischemic stroke, myocardial infarction, major vascular surgery) for survival analysis.

Main Results:

  • Median survival time was 67 months, with a 10-year cumulative survival rate of 34%.
  • Among 347 patients with event data, 78 experienced 92 vascular events.
  • 10-year cumulative hazard for any vascular event was 47%, with recurrent ICH (8.9%), ischemic stroke (11%), myocardial infarction (3.7%), and major vascular surgery (1.4%) observed.

Conclusions:

  • The long-term prognosis for cerebellar ICH survivors is poor, comparable to supratentorial ICH survivors.
  • There is a significant risk of recurrent vascular events, necessitating further risk identification.
  • Randomized controlled trials for secondary prevention in cerebellar ICH patients are warranted.
Abstract

Keywords:
cerebellumcohort studieshemorrhagic strokerecurrencestrokesurvival

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