Prognostic aspect of cerebellar hematomas in tropical environments: Study of 33 cases at Conakry University Hospital

Abstract

Abstract Background : Cerebellar hematoma is thought to result from a collection of blood in the cerebellar parenchyma. It is a rare topographical form, accounting for 5-10% of hemorrhagic strokes, with an unpredictable and often dreadful prognosis. The aim of our study is to determine the prognostic factors of cerebellar hematomas in the Neurology Department of the CHU Ignace Deen in Conakry. Methodology: We conducted a retrospective descriptive study lasting four (4) years, from June 1, 2017 to May 31, 2021, in the neurology department of the CHU de Conakry, focusing on patients hospitalized with a cerebellar hematoma confirmed by cerebral CT scan. The variables were epidemiological, clinical, therapeutic and prognostic. Any p-value < 0.05 was considered statistically significant. Results: A total of 33 patients, representing 9.7% of cerebellar hematomas, with a mean age of 60±12.50 years, ranging from 33 to 82 years, and a male predominance of 69.7% (sex ratio 2.3). Hypertension was the main risk factor in 87.9% of cases. The main symptoms were headache in 90.9% of cases, dizziness in 81.8% and vomiting in 60.6%. The factor associated with a favorable outcome was an ICH score≤ 2 (p-value = 0.004)). The mortality rate was 27.3%. A favorable outcome without sequelae was observed in 18.2% of cases, versus 54.6% in cases with neurological sequelae. Conclusion: At the end of this study, we concluded that cerebellar hematoma constitutes a diagnostic and therapeutic emergency. High ICH and modified Rankin at re-entry were poor prognostic factors associated with functional sequelae and a high mortality rate.