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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
Summary
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.
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