Cerebellar strokes: mortality, surgical indications, and results of ventricular drainage.

A series of 15 patients with cerebellar haemorrhages and 55 with cerebellar infarcts diagnosed by computerised tomography were studied. 9 haemorrhage patients and 49 infarct patients did not have hydrocephalus; 7 and 44, respectively, survived. All 12 patients with hydrocephalus deteriorated and were subjected to ventricular drainage, 4 of the 6 haemorrhage patients with hydrocephalus survived, 2 in a functional neurological state. All 6 infarct patients with hydrocephalus survived in good condition after ventricular drainage. Hydrocephalus developed in patients with cerebellar haemorrhage more frequently and sooner after the stroke than in patients with cerebellar infarct. Once hydrocephalus had developed, deterioration was more rapid in haemorrhage patients. The most important determining factor in the survival of patients with cerebellar stroke is whether hydrocephalus develops. Consequently, the indication for surgical intervention is the presence of hydrocephalus. Ventricular drainage was effective in the treatment of patients with hydrocephalus accompanying cerebellar stroke, and it is likely that direct surgical attack is unnecessary.