Cerebellar Hemorrhage Workup

  • Author: J Stephen Huff, MD; Chief Editor: Helmi L Lutsep, MD   more...
 
Updated: Apr 24, 2012
 

Laboratory Studies

  • Obtain coagulation studies and a platelet count in all patients, particularly those taking anticoagulant medication.
  • Obtain other admission laboratory work (including a specimen for blood type and crossmatch) if surgery is a possibility.
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Imaging Studies

  • CT: Acute CH should be visible as increased density in the posterior fossa. Large hemorrhage of cerebellar vermis. Large hemorrhage of cerebellar vermis.
    • Note the location of the hematoma (central versus lobar) and any sign of brainstem compression.
    • Note the absolute size of the clot in maximum diameter.
    • Other signs of a posterior fossa mass include ablation of the fourth ventricle and/or compression of the ambient and quadrigeminal cisterns.
    • Note any obstructive hydrocephalus.
  • MRI may be important later in the clinical course to define vascular anatomy, extent of damage, and other pertinent intracranial abnormalities (eg, tumor, arteriovenous malformation).
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Contributor Information and Disclosures
Author

J Stephen Huff, MD  Associate Professor of Emergency Medicine and Neurology, Department of Emergency Medicine, University of Virginia School of Medicine

J Stephen Huff, MD is a member of the following medical societies: American Academy of Emergency Medicine, American Academy of Neurology, American College of Emergency Physicians, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Draga Jichici, MD, FRCP, FAHA  Associate Clinical Professor, Department of Neurology and Critical Care Medicine, McMaster University School of Medicine, Canada

Draga Jichici, MD, FRCP, FAHA is a member of the following medical societies: American Academy of Neurology, Canadian Congress of Neurological Sciences, Canadian Congress of Neurological Sciences, Canadian Congress of Neurological Sciences, Canadian Critical Care Society, Canadian Medical Protective Association, Canadian Neurocritical Care Society, Neurocritical Care Society, Royal College of Physicians and Surgeons of Canada, and Society of Critical Care Medicine (USA)

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Howard S Kirshner, MD  Professor of Neurology, Psychiatry and Hearing and Speech Sciences, Vice Chairman, Department of Neurology, Vanderbilt University School of Medicine; Director, Vanderbilt Stroke Center; Program Director, Stroke Service, Vanderbilt Stallworth Rehabilitation Hospital; Consulting Staff, Department of Neurology, Nashville Veterans Affairs Medical Center

Howard S Kirshner, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Neurology, American Heart Association, American Medical Association, American Neurological Association, American Society of Neurorehabilitation, National Stroke Association, Phi Beta Kappa, and Tennessee Medical Association

Disclosure: Nothing to disclose.

Selim R Benbadis, MD  Professor, Director of Comprehensive Epilepsy Program, Departments of Neurology and Neurosurgery, Tampa General Hospital, University of South Florida College of Medicine

Selim R Benbadis, MD is a member of the following medical societies: American Academy of Neurology, American Academy of Sleep Medicine, American Clinical Neurophysiology Society, American Epilepsy Society, and American Medical Association

Disclosure: UCB Pharma Honoraria Speaking, consulting; Lundbeck Honoraria Speaking, consulting; Cyberonics Honoraria Speaking, consulting; Glaxo Smith Kline Honoraria Speaking, consulting; Pfizer Honoraria Speaking, consulting; Sleepmed/DigiTrace Honoraria Speaking, consulting

Chief Editor

Helmi L Lutsep, MD  Professor and Vice Chair, Department of Neurology, Oregon Health and Science University School of Medicine; Associate Director, Oregon Stroke Center

Helmi L Lutsep, MD is a member of the following medical societies: American Academy of Neurology and American Stroke Association

Disclosure: Co-Axia Consulting fee Review panel membership; AGA Medical Consulting fee Review panel membership; Concentric Medical Consulting fee Review panel membership

References

  1. Brockmann MA, Groden C. Remote cerebellar hemorrhage: a review. Cerebellum. 2006;5(1):64-8. [Medline].

  2. Konya D, Ozgen S, Pamir MN. Cerebellar hemorrhage after spinal surgery: case report and review of the literature. Eur Spine J. Jan 2006;15(1):95-9. [Medline].

  3. Young YR, Lee CC, Sheu BF, Chang SS. Neurogenic cardiopulmonary complications associated with spontaneous cerebellar hemorrhage. Neurocrit Care. 2007;7(3):238-40. [Medline].

  4. Amar AP. Controversies in the neurosurgical management of cerebellar hemorrhage and infarction. Neurosurg Focus. Apr 2012;32(4):E1. [Medline].

  5. [Guideline] Broderick J, Connolly S, Feldmann E, Hanley D, Kase C, Krieger D, et al. Guidelines for the management of spontaneous intracerebral hemorrhage in adults: 2007 update: a guideline from the American Heart Association/American Stroke Association Stroke Council, High Blood Pressure Research Council, and the Quality of Care and Outcomes in Research Interdisciplinary Working Group. Stroke. Jun 2007;38(6):2001-23. [Medline].

  6. [Guideline] Morgenstern LB, Hemphill JC 3rd, Anderson C, Becker K, Broderick JP, Connolly ES Jr, et al. Guidelines for the management of spontaneous intracerebral hemorrhage: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. Sep 2010;41(9):2108-29. [Medline].

  7. St Louis EK, Wijdicks EF, Li H. Predicting neurologic deterioration in patients with cerebellar hematomas. Neurology. Nov 1998;51(5):1364-9. [Medline].

  8. Mohadjer M, Eggert R, May J, Mayfrank L. CT-guided stereotactic fibrinolysis of spontaneous and hypertensive cerebellar hemorrhage: long-term results. J Neurosurg. Aug 1990;73(2):217-22. [Medline].

  9. Yamamoto T, Nakao Y, Mori K. Endoscopic hematoma evacuation for hypertensive cerebellar hemorrhage. Minim Invasive Neurosurg. Jun 2006;49(3):173-8. [Medline].

  10. Deininger MH, Adam A, Van Velthoven V. Free-hand bedside catheter evacuation of cerebellar hemorrhage. Minim Invasive Neurosurg. Feb 2008;51(1):57-60. [Medline].

 
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Large hemorrhage of cerebellar vermis.
 
 
 
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