[Spontaneous hematomas of the cerebellum. 28 personal cases].

Cerebellar hematomas constitute an emergency as emphasized by a study of 28 personal and 189 published cases. Accounting for 10 per cent of the total of cerebral hemorrhages, they occur mainly in patients after 40 years of age essentially as a complication of hypertension. An evocative stereotyped triad characterizes their sudden onset: severe headache, repeated vomiting, vertigo and imbalance. In their subacute and acute forms, a rapid impairment of consciousness occurs. Death is constant in such cases. Computerized axial tomography is the essential mean of accurate diagnosis and shows the subsequent consequences on other brain structures. Surgical evacuation of hematomas preceded or not by ventricular drainage is the useful procedure in most cases. Results depend on a timely decision and on the conscious level. In other cases, the spontaneous course is more favorable. Brain herniation is however possible and the presence of a vascular posterior fossa malformation must be kept in mind.