Objective
To present the local experience of decompressive surgery in massive cerebellar strokes at Shifa
International Hospital, Islamabad.
Patients and Methods
This retrospective non-randomized case series included six patients operated at Shifa
International Hospital, Islamabad from October 2003 to July 2008 for cerebellar stroke.
Decompression with or with out external ventricular drain was performed. Functional status at
follow up was evaluated by Glasgow Outcome Scale.
Results
Out of six patients with cerebellar stroke, one had cerebellar hemorrhage while others had
cerebellar infarction. Mean age was 60 years and male to female ratio was 1:1. In three cases
ventricular drainage with posterior decompressive craniectomy was done. All were operated
when they developed deterioration in conscious level. Five patients were discharged with
Glasgow Outcome Scale of 3 to 5 (severe disability to good recovery). One patient who died had
simultaneous brain stem involvement.
Conclusion
Early decompressive surgery is life saving for massive cerebellar strokes, while concomitant
brainstem involvement carries poor prognosis. All patients with cerebellar stroke should be comanaged
by neurology and neurosurgery services in the initial phase to help with quick
intervention, if indicated. (Rawal Med J 2010;35: ).
Key words: Cerebellar stroke, decompressive surgery, external ventricular drain.
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