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원발성 소뇌출혈 1예 보고 A Case of Spontaneous Cerebellar Hemorrhage

대한신경외과학회지 1977년 6권 1호 p.93 ~ 101
박기용, 강준기, 송진언,
소속 상세정보
박기용 (  ) 
가톨릭의과대학 신경외과학 교실

강준기 (  ) 
가톨릭의과대학 신경외과학 교실
송진언 (  ) 
가톨릭의과대학 신경외과학 교실

Abstract


Spontaneous cerebellar hemorrhage is classically considered a rare and fatal disease because the early diagnosis is very rarely made during the life, and there is scant mention of. the problems of spontaneous hemorrhage into the cerebellar hemisphere. However our opinions indicate that its frequency is greater than is generally thought although it is considereii a rare lesion.
The purpose of this paper is..to record our present opinions concerning the possible early diagnosis and surgical management of the spontaneous cerebellar hemorrhage.´ We believe that it is possible by clinical examination alone to make or strongly suspect the diagnosis in life during the early stage before irreversible damage occurs and that emergency surgical intervention is strongly indicated.
The patient is a 38 year old man admitted to the Department of Neurosurgery, Catholic Medical Center on Nov. 3, 1976 with severe headache, vomiting, dysarthria and mental confusion.
On examination, he. was disclosed mental confusion, repeated vomiting, constricted pupil, horizontal nystagmus, inability to stand, dysarthria and neck stiffness,
We confirmed the diagnosis under the cerebellar hemorrhage involving the cerebellar vermis and both cereballar hemispheres by means of vertebral and carotid angiography, conray ventriculography, and cerebrospinal fluid examination.
We underwent suboccipital craniectomy with the evacuation of hematoma at the vermis and both cerebellar hemispheres after 48 hours of onset of illness and his postoperative course was good except for mild cerebellar dysfunction signs and he was discharged on 45th hospital days.

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