Cerebellar hemorrhage. A review and reappraisal of benign cases

We reviewed 17 cases of cerebellar hemorrhage that occurred in our institutions over a five-year period. Nine of these patients had a benign immediate outcome, recovering without surgery. One patient died four weeks later of septicemia. We reviewed the clinical and radiological features of benign cases from our institutions and from the literature. Our results indicate that there is no single determinant that will confidently predict such a benign outcome in a given patient. The size of the hemorrhage, its location, and the level of consciousness of the patient had no consistent bearing on outcome. However, marked hydrocephalus or deteriorating level of consciousness indicated a poor prognosis, irrespective of the choice of therapy. Benign outcomes were not confined only to those who were alert or had small laterally placed hemorrhages. We were able to identify unequivocal hypertension, preceding the hemorrhage, in only four of our 17 patients.