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Incidence and Clinical Features of Intracerebral Hemorrhage in the Cerebellum and Brainstem : 231 Consecutive Cases

Troberg, Ebba LU ; Ramgren, Birgitta LU ; Hansen, Björn M. LU orcid ; Lindgren, Arne G. LU ; Kronvall, Erik LU and Nilsson, Ola G. LU (2026) In Acta Neurologica Scandinavica 2026(1). p.1-9
Abstract

Background: Intracerebral hemorrhage (ICH) in the posterior fossa, that is, cerebellum and brainstem, often has a poor prognosis. Treatment options are limited. However, primary preventive measures may have changed during the last decades. We aimed to study the hospitalization-based incidence and characteristics of posterior fossa ICH and examine whether these changed during a 13-year period. Methods: In this cohort study, we identified patients hospitalized due to spontaneous posterior fossa ICH at Skåne University Hospital from 2003 to 2015 registered in Riksstroke, a national stroke quality registry. We calculated incidence by using the direct method, weighted to the Swedish and European populations. Baseline characteristics,... (More)

Background: Intracerebral hemorrhage (ICH) in the posterior fossa, that is, cerebellum and brainstem, often has a poor prognosis. Treatment options are limited. However, primary preventive measures may have changed during the last decades. We aimed to study the hospitalization-based incidence and characteristics of posterior fossa ICH and examine whether these changed during a 13-year period. Methods: In this cohort study, we identified patients hospitalized due to spontaneous posterior fossa ICH at Skåne University Hospital from 2003 to 2015 registered in Riksstroke, a national stroke quality registry. We calculated incidence by using the direct method, weighted to the Swedish and European populations. Baseline characteristics, clinical admission features, and radiology were obtained from medical records and Riksstroke. We also compared the first half with the latter half of the observation period. Results: We identified 139 cases of cerebellar and 92 of brainstem ICH. The hospitalization-based incidence was 2.7 for cerebellar and 1.8 for brainstem ICH per 100,000 person-years. The most prevalent comorbidities were hypertension and cerebral white matter lesions. Patients with cerebellar ICH were older, more frequently female, and more likely to have hypertension, heart disease, or anticoagulant/antiplatelet medications compared to those with brainstem ICH. Patients with brainstem ICH more often were unconscious or had abnormal pupillary reactions at admission. Patients affected during the latter half of the study period were older, and more often had hypertension or ongoing anticoagulant therapy. Conclusion: The hospitalization-based incidence of posterior fossa ICH was 4.4 per 100,000 per person-years in this large cohort study of a defined population. Posterior fossa ICH, particularly in the cerebellum, was strongly linked to cardiovascular disease risk factors.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
brainstem, cerebellum, incidence, intracerebral hemorrhage, posterior fossa
in
Acta Neurologica Scandinavica
volume
2026
issue
1
article number
2499041
pages
1 - 9
publisher
Wiley-Blackwell
external identifiers
  • scopus:105043383671
ISSN
0001-6314
DOI
10.1155/ane/2499041
language
English
LU publication?
yes
additional info
Publisher Copyright: Copyright © 2026 Ebba Troberg et al. Acta Neurologica Scandinavica published by John Wiley & Sons Ltd.
id
3823aa81-dc40-4db9-b715-64786d091e56
date added to LUP
2026-09-01 21:07:11
date last changed
2026-09-02 07:30:34
@article{3823aa81-dc40-4db9-b715-64786d091e56,
  abstract     = {{<p>Background: Intracerebral hemorrhage (ICH) in the posterior fossa, that is, cerebellum and brainstem, often has a poor prognosis. Treatment options are limited. However, primary preventive measures may have changed during the last decades. We aimed to study the hospitalization-based incidence and characteristics of posterior fossa ICH and examine whether these changed during a 13-year period. Methods: In this cohort study, we identified patients hospitalized due to spontaneous posterior fossa ICH at Skåne University Hospital from 2003 to 2015 registered in Riksstroke, a national stroke quality registry. We calculated incidence by using the direct method, weighted to the Swedish and European populations. Baseline characteristics, clinical admission features, and radiology were obtained from medical records and Riksstroke. We also compared the first half with the latter half of the observation period. Results: We identified 139 cases of cerebellar and 92 of brainstem ICH. The hospitalization-based incidence was 2.7 for cerebellar and 1.8 for brainstem ICH per 100,000 person-years. The most prevalent comorbidities were hypertension and cerebral white matter lesions. Patients with cerebellar ICH were older, more frequently female, and more likely to have hypertension, heart disease, or anticoagulant/antiplatelet medications compared to those with brainstem ICH. Patients with brainstem ICH more often were unconscious or had abnormal pupillary reactions at admission. Patients affected during the latter half of the study period were older, and more often had hypertension or ongoing anticoagulant therapy. Conclusion: The hospitalization-based incidence of posterior fossa ICH was 4.4 per 100,000 per person-years in this large cohort study of a defined population. Posterior fossa ICH, particularly in the cerebellum, was strongly linked to cardiovascular disease risk factors.</p>}},
  author       = {{Troberg, Ebba and Ramgren, Birgitta and Hansen, Björn M. and Lindgren, Arne G. and Kronvall, Erik and Nilsson, Ola G.}},
  issn         = {{0001-6314}},
  keywords     = {{brainstem; cerebellum; incidence; intracerebral hemorrhage; posterior fossa}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{1--9}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Acta Neurologica Scandinavica}},
  title        = {{Incidence and Clinical Features of Intracerebral Hemorrhage in the Cerebellum and Brainstem : 231 Consecutive Cases}},
  url          = {{http://dx.doi.org/10.1155/ane/2499041}},
  doi          = {{10.1155/ane/2499041}},
  volume       = {{2026}},
  year         = {{2026}},
}