Goncharuk O. Spontaneous hemorrhages to the posterior cranial fossa. Clinic, diagnostics, prognosis

On the base of complex examination of 312 patients with spontaneous hemorrhages in posterior cranial fossa (PCF) - their etiopathogenesis, localization and clinical signs have been studied. It was shown that hemorrhages main reasons were arterial hypertension, arterial aneurysm, arteriovenous malformation and cavernous angiomas. Hemorrhages in the PCF, regardless etiologic factors, are more likely in men (56.4±2.8%) than in women (43.6±2.8%). At arterial hypertension hemorrhages mainly occurred into PCF parenchymal structures, and almost twice as often into brain stem than cerebellum (respectively 59.4±3.8% and 36.5±3.8%); in 4.1% cases diffuse hemorrhages into cerebellum and brain stem were diagnosed (P<0.05). Hemorrhages into deep structures of cerebellum and brain stem dominated, stem hemorrhages were characterized by severe clinical flow. Hypertensive hemorrhages into brain stem more frequently than in cerebellum complicated by and subarachnoid and intraventricular blood breakthrough. Subarachnoid hemorrhages caused by arterial aneurysms' rupture often (73.5±4.3%) have uncomplicated flow, without dislocation syndrome. Subarachnoid-parenchymal as subarachnoid-parenchymal-intraventricular hemorrhages with dislocation syndrome occurred rarely (respectively 9.2±2.9% and 8.2±2.8%). Subarachnoid-intraventricular hemorrhage, complicated by hydrocephaly development, was rare (7.1±2.8%). At PCF arteriovenous malformations subarachnoid hemorrhages and blood breakthrough into brain stem were less often (12.5±2.2%) than in cerebellum (87.5±8.2%). Hemorrhages into cerebellum parenchyma often were superficial. PCF arteriovenous malformations are characterized by recurrent hemorrhages. Delimited subependimal hematomas in brain stem that move apart tissues without destroying them, more often are caused by cavernous angiomas. The hemorrhage deepens present local tumor-like symptoms. Massive hemorrhages into brain stem causes disorders of liquor circulation. The algorithm for diagnostics of PCF hemorrhages depending on their localization, clinical signs and etiologic factors was worked out. Main prognostic criteria of PCF hemorrhages depending on their location, causes and clinical signs were identified that allow to select optimal algorithm for diagnostics and patients' treatment. Key words: posterior cranial fossa, malformation, arterial hypertension, angiography, computer tomography, diagnostics, prognosis.