The dissertation is devoted to features of the course and criteria prognosis of acute cerebellar hemorrhage. Clinical and instrumental studies of 96 patients have been performed. The patients were divided by Glasgow outcome scale (GOS) at discharge into the favorable outcome group (GOS score 5 and 4), the poor outcome group (GOS score 3) and fatal outcome group (GOS score 1). Patients with GOS of 2 were absent.
It has been found out, that patients with acute cerebellar hemorrhage are characterized by most frequently in the 5th through the 7th decades of life, almost equal frequency of men and women, acute onset, dizziness and headache, high systolic blood pressure, presentation from moderate symptoms to catastrophic neurologic decline, impairment of consciousness, the presence of various neurological symptoms, localization of hematoma predominantly in the cerebellar hemisphere, lesions mostly right cerebellar structures, the prevalence of massive hematomas (> 3 cm in maximum diameter), resizing ventricular system of the brain and brainstem compression, hyperchromemia in women and hyperglycemia in patients of both sexes. Was revealed the association between indicators of systolic and diastolic blood pressure, tachycardia, level of consciousness, signs of cranial nerves lesion and lesion of pyramidal tract, sensitivity disorder, presence of diabetes mellitus type 2, localization of hematoma, indicators of volume and maximum diameter of hematoma, width of anterior horns of the lateral ventricles and perifocal edema around the hematoma, signs of brainstem compression, presence of intraventricular hemorrhage, admission blood urea, total white blood cell count, absolute neutrophil count, absolute lymphocyte count and outcome in patients with acute hypertensive cerebellar hemorrhage.
Were dedicated basic principles of predicting the consequences of acute cerebellar hemorrhage, which mainly based on the assessment of the level of consciousness on admission, values of volume and diameter of hematoma and degree of brainstem compression. Was designed prognostic system of outcome in patients with acute hypertensive cerebellar hemorrhage, which allows to predict the consequences with high degree of confidence on admission during applying neurological and radiological methods of investigation, contributing to the creation of an effective strategy for treatment as soon as possible.
