Abstract :
Background: Patients with cerebellar infarction are threatened by infratentorial herniation and impaired circulation of cerebrospinal fluid if mass effect in posterior fossa develops, the mortality without operation was very high. With surgical treatment, the mortality was reduced considerably. Objective: The aim of this study was to evaluate early surgical management of cerebellar infarction in patients who exhibits progressive neurological deterioration Clinical Material And Methods: Review was made of eight patients with acute cerebellar infarction. The clinical findings were headache, dizziness, dysarthria, focal motor weakness, limb and/or trunk ataxia vomiting and rapid impairment of level of consciousness. Computed tomography (CT) examination is essential in the diagnosis of ictus and decision for operative treatment. Mass effect of cerebellar infarction was assessed using a 3-item: compression of fourth ventricle, quadrigeminal cistern, and of lateral ventricle. MRI was done only for one patient after stabilization of her clinical status. Initially all patients received medical treatment ( dehydrating measures), patients who had GCS 4 intubated and connected to mechanical ventilation Surgical interventions were considered for all patients involved in this small study . A temporary external ventricular drainage (EVD) were inserted in six patients, five of them didn t improve and suboccipital decompression with resection of bulging infracted tissue were done. The sixth patient get marked improvement after EVD and ventriculoperitoneal shunt was inserted in the second day. Two patient directly underwent suboccipital decompression without EVD.
