Surgical decompression in massive cerebellar stroke

Objective To present the local experience of decompressive surgery in massive cerebellar strokes at Shifa International Hospital, Islamabad. Patients and Methods This retrospective non-randomized case series included six patients operated at Shifa International Hospital, Islamabad from October 2003 to July 2008 for cerebellar stroke. Decompression with or with out external ventricular drain was performed. Functional status at follow up was evaluated by Glasgow Outcome Scale. Results Out of six patients with cerebellar stroke, one had cerebellar hemorrhage while others had cerebellar infarction. Mean age was 60 years and male to female ratio was 1:1. In three cases ventricular drainage with posterior decompressive craniectomy was done. All were operated when they developed deterioration in conscious level. Five patients were discharged with Glasgow Outcome Scale of 3 to 5 (severe disability to good recovery). One patient who died had simultaneous brain stem involvement. Conclusion Early decompressive surgery is life saving for massive cerebellar strokes, while concomitant brainstem involvement carries poor prognosis. All patients with cerebellar stroke should be comanaged by neurology and neurosurgery services in the initial phase to help with quick intervention, if indicated.