This study presents 42 patients with cerebellar infarctions; 27 patients were studied retrospectively, 15 patients were studied prospectively according to a fixed protocol. Rating of the clinical status using an adapted classification schema according to Heros with additional neuroimaging and neurophysiological data was found to be a reliable tool to estimate the severity of the disease. Evoked potential studies are useful and reliable to monitor the clinical course and to estimate the severity of the disease (i.e. BAEP) or predict outcome (i.e. SSEP). Treatment should be determined by the severity of the disease, i.e. awake and drowsy patients can be treated either medically or with ventriculostomy, if hydrocephalus occurs. In comatose patients decompressive surgery is significantly superior to ventriculostomy (p < 0.05). The analysis of the preliminary data suggests surgical decompression of the posterior fossa as the optimum therapeutic regimen in obtunded patients presenting with occlusive hydrocephalus and signs of brainstem compression. An open multicenter trial in Austria and Germany is in progress to confirm the results of this pilot study.
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Rieke et al. (2007) studied this question.