gms | German Medical Science

Objective: Cerebellar hemorrhage is a potentially lifethreatening condition and an understanding of the factors influencing outcome is essential for sound clinical decision-making. The aim of our to present the short-term course of patients suffering from a spontaneous cerebellar hemorrhage and to evaluate possible in-hospital outcome predictors.

Methods: We retrospectively evaluated data from 50 consecutive patients, who suffered a first spontaneous cerebellar hemorrhage (SCH) from 2009 to 2014, analyzing their short-term outcomes and identifying possible clinical, radiological and therapeutic risk factors for poor prognosis and death within 30 days.

Results: Among 50 patients with first SCH, the mean age was 72 ± 10 years. Median Glasgow Coma Scale (GCS) score on admission was 11 (IQR = 7 - 11). 19 patients (38%) underwent surgical hemorrhage evacuation with placement of an external ventricular drain (EVD), 12 patients (24%) received an EVD only and 19 patients (38) were treated conservatively. The 30-day mortality rate was 36%. In multivariate analysis only the admission GCS score was a significant predictor of 30-day mortality (OR = 0.598; 95% CI = 0.406 - 0.879; p = 0.009). For prediction of 30-day mortality, receiver operating characteristic (ROC) curve analysis confirmed that the best cut-off point was a GCS score of 10 on admission (AUC: 0.882, 95% CI = 0.717 - 1, p < 0.001).

Conclusion: Lower GCS score on admission was associated with increased 30-day mortality and poorer short-term outcome in patients with SCH. For patients with a GCS score < 10 on admission, it is important to balance the possibility of survival afforded by further therapy against the formidable risk of significant functional disability and poor quality of life.