[Cerebellar hematomas and infarcts. Clinical and cerebral computerized tomographic findings]

Vascular accidents of the cerebellum are traditionally considered to be very difficult to diagnose, and as spontaneously following a fatal course without neurosurgical decompressive intervention. Such views are undoubtedly due to the fact that usually only the most serious vascular accidents of the cerebellum are diagnosed prior to surgical intervention or autopsy. Following 12 observations (2 hematomas and 5 infarcts) using computerized tomography, which facilitates the diagnosis of less severe forms, the authors suggest that some changes are necessary in the classic view of these disorders. From a clinical point of view, they point out the consistency of a cerebellar syndrome in their series and the subtlety of disturbances of consciousness. They also stress the possibility, verified in 10 these 12 cases, of a favourable outcome with medical treatment alone. The CT scan not only facilitates the diagnosis of vascular accidents of cerebellum, but can distinguish between hematomas and infarcts (the incidence of the latter has certainly been underestimated until now). Furthermore, the CT scan allows direct clinico-anatomical surveillance of the lesion, and equally importantly of its possible obstructing effects on the ventricular system.