Nontraumatic intracerebellar hematomas: prognostic value of volumetric evaluation by computed tomography

Thirty-two consecutive cases of nontraumatic intracerebellar hematomas detected by computed tomography are reviewed. A strong correlation was found between the clinical course and the volumetrically calculated size of the hematomas. Prompt evacuation has the best prognosis in cases that have an acute or subacute course (hematoma size, 22.5 to 66 cm3). Conservative treatment was most successful in chronic cases (hematoma size, 8 to 16 cm3). Surgical treatment should be the treatment of choice in very acute cases also (hematoma size, over 70 cm3) if the hematoma is diagnosed immediately after the onset of bleeding. Early detection and volumetric evaluation by computed tomography have great prognostic value for managing nontraumatic intracerebellar hematomas.