Advanced

Prognostic factors and long-term outcome following surgical treatment of 76 patients with spontaneous cerebellar haematoma

Tsitsopoulos, Parmenion P; Tobieson, Lovisa; Enblad, Per and Marklund, Niklas LU (2012) In Acta Neurochirurgica 154(7). p.95-1189
Abstract

BACKGROUND: Although large spontaneous cerebellar haematomas are associated with high mortality, surgical treatment may be life-saving. We evaluated the clinical outcome and identified prognostic factors in 76 patients with cerebellar haematoma, all treated with suboccipital decompression, haematoma evacuation and external ventricular drainage.

METHODS: Patients receiving surgical and neurocritical care treatment within a 10-year period were included. Level of consciousness during hospitalisation was evaluated using the Glasgow Coma Scale (GCS) score. Outcome was assessed with the modified Rankin Scale (mRS). Predictive prognostic factors were analysed using univariate and multivariate regression analysis.

RESULTS: Prior to... (More)

BACKGROUND: Although large spontaneous cerebellar haematomas are associated with high mortality, surgical treatment may be life-saving. We evaluated the clinical outcome and identified prognostic factors in 76 patients with cerebellar haematoma, all treated with suboccipital decompression, haematoma evacuation and external ventricular drainage.

METHODS: Patients receiving surgical and neurocritical care treatment within a 10-year period were included. Level of consciousness during hospitalisation was evaluated using the Glasgow Coma Scale (GCS) score. Outcome was assessed with the modified Rankin Scale (mRS). Predictive prognostic factors were analysed using univariate and multivariate regression analysis.

RESULTS: Prior to surgery, the median GCS score was 8.6 (range 3-13). At discharge it had improved to 12.1 (4-15) (p < 0.05). The median long-term follow-up period was 70.5 (22-124) months. At 6 months post-surgery, 19 patients were dead and 28 patients had a good outcome (mRS < 3). In the long term (70.5 months), 31 patients (41.9 %) were dead and the outcome was good in 27 patients (37.8 %). Although approximately 25 % of patients >65 years old had a favourable outcome, age was the strongest negative predictor for a bad outcome at 6 months and long term (p = 0.02 and p = 0.01, respectively). The level of consciousness before surgery did not influence the 6-month or long-term outcome (p = 0.39 and p = 0.65, respectively).

CONCLUSIONS: Although mortality was high, significant complications from the treatment were rare and most survivors had a good outcome, reaching functional independence. High age was the strongest prognostic factor for an unfavourable outcome.

(Less)
Please use this url to cite or link to this publication:
author
publishing date
type
Contribution to journal
publication status
published
keywords
Adult, Age Factors, Aged, Cerebellar Diseases, Decompression, Surgical, Female, Follow-Up Studies, Glasgow Coma Scale, Hematoma, Humans, Male, Middle Aged, Postoperative Complications, Prognosis, Retrospective Studies, Survival Rate, Sweden
in
Acta Neurochirurgica
volume
154
issue
7
pages
95 - 1189
publisher
Springer
external identifiers
  • scopus:84865761087
ISSN
0001-6268
DOI
10.1007/s00701-012-1372-7
language
English
LU publication?
no
id
1d6b2a5c-2707-498c-926b-7004aa370bf2
date added to LUP
2018-03-04 11:47:53
date last changed
2018-10-03 12:11:02
@article{1d6b2a5c-2707-498c-926b-7004aa370bf2,
  abstract     = {<p>BACKGROUND: Although large spontaneous cerebellar haematomas are associated with high mortality, surgical treatment may be life-saving. We evaluated the clinical outcome and identified prognostic factors in 76 patients with cerebellar haematoma, all treated with suboccipital decompression, haematoma evacuation and external ventricular drainage.</p><p>METHODS: Patients receiving surgical and neurocritical care treatment within a 10-year period were included. Level of consciousness during hospitalisation was evaluated using the Glasgow Coma Scale (GCS) score. Outcome was assessed with the modified Rankin Scale (mRS). Predictive prognostic factors were analysed using univariate and multivariate regression analysis.</p><p>RESULTS: Prior to surgery, the median GCS score was 8.6 (range 3-13). At discharge it had improved to 12.1 (4-15) (p &lt; 0.05). The median long-term follow-up period was 70.5 (22-124) months. At 6 months post-surgery, 19 patients were dead and 28 patients had a good outcome (mRS &lt; 3). In the long term (70.5 months), 31 patients (41.9 %) were dead and the outcome was good in 27 patients (37.8 %). Although approximately 25 % of patients &gt;65 years old had a favourable outcome, age was the strongest negative predictor for a bad outcome at 6 months and long term (p = 0.02 and p = 0.01, respectively). The level of consciousness before surgery did not influence the 6-month or long-term outcome (p = 0.39 and p = 0.65, respectively).</p><p>CONCLUSIONS: Although mortality was high, significant complications from the treatment were rare and most survivors had a good outcome, reaching functional independence. High age was the strongest prognostic factor for an unfavourable outcome.</p>},
  author       = {Tsitsopoulos, Parmenion P and Tobieson, Lovisa and Enblad, Per and Marklund, Niklas},
  issn         = {0001-6268},
  keyword      = {Adult,Age Factors,Aged,Cerebellar Diseases,Decompression, Surgical,Female,Follow-Up Studies,Glasgow Coma Scale,Hematoma,Humans,Male,Middle Aged,Postoperative Complications,Prognosis,Retrospective Studies,Survival Rate,Sweden},
  language     = {eng},
  number       = {7},
  pages        = {95--1189},
  publisher    = {Springer},
  series       = {Acta Neurochirurgica},
  title        = {Prognostic factors and long-term outcome following surgical treatment of 76 patients with spontaneous cerebellar haematoma},
  url          = {http://dx.doi.org/10.1007/s00701-012-1372-7},
  volume       = {154},
  year         = {2012},
}