Acute obstructive hydrocephalus caused by cerebellar infarction. Treatment alternatives

The treatment alternatives for the patient who becomes comatose following nontraumatic infarction of the cerebellum are discussed. The acute hydrocephalus produced by the swollen cerebellum is readily diagnosed by computed tomography scan and is identified as a hypodense mass without contrast medium uptake that obliterates the fourth ventricle. Two typical cases are described, one managed medically and one surgically. All available reports in the world literature of similar patients treated surgically are reviewed. Based on the outcome analysis of the foregoing, a strategy is offered for the handling of future cases.