Predictors of poor outcome in patients with a spontaneous cerebellar hematoma

Erik K St Louis, Eelco F M Wijdicks, Hongzhe Li, John D. Atkinson

Research output: Contribution to journalArticle

42 Citations (Scopus)

Abstract

Background and purpose: The authors studied the clinical and neuroimaging features of cerebellar hematomas to predict poor outcome using comprehensive statistical models. Methods: We retrospectively reviewed clinical and neuroimaging features in 94 patients with spontaneous cerebellar hematomas to identify predictive features for a poor neurologic outcome, defined is death or dismissal to long-term care facility. Data were analyzed using chi square and Fisher's exact test with calculation of odd's ratios together with 95% confidence intervals. Results: Clinical and neuroradiologic predictors for a poor outcome at p < 0.05 were admission systolic blood pressure > 200 mm Hg, hematoma size >3 cm, visible brain stem distortion, and acute hydrocephalus. Presenting findings predicting subsequent death at p < 0.05 were abnormal corneal and oculocephalic responses, Glasgow coma sum score less than 8, motor response less than localization to pain, acute hydrocephalus and intraventricular hemorrhage. Conclusion: A tree-based analysis model using binary recursive partitioning showed that cornea reflex, hydrocephalus, doll's eyes, age, and size were the most important discriminating factors. Absent corneal reflexes on admission highly predicts poor outcome (86 percent, confidence limits 67-96 percent). When a cornea reflex is present, acute hydrocephalus predicts poor outcome but only when doll's eyes are additionally absent.

Original languageEnglish (US)
Pages (from-to)32-36
Number of pages5
JournalCanadian Journal of Neurological Sciences
Volume27
Issue number1
StatePublished - 2000

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Hydrocephalus
Hematoma
Neuroimaging
Cornea
Reflex
Abnormal Reflexes
Long-Term Care
Statistical Models
Coma
Nervous System
Brain Stem
Odds Ratio
Confidence Intervals
Hemorrhage
Pain

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

Cite this

Predictors of poor outcome in patients with a spontaneous cerebellar hematoma. / St Louis, Erik K; Wijdicks, Eelco F M; Li, Hongzhe; Atkinson, John D.

In: Canadian Journal of Neurological Sciences, Vol. 27, No. 1, 2000, p. 32-36.

Research output: Contribution to journalArticle

St Louis, Erik K ; Wijdicks, Eelco F M ; Li, Hongzhe ; Atkinson, John D. / Predictors of poor outcome in patients with a spontaneous cerebellar hematoma. In: Canadian Journal of Neurological Sciences. 2000 ; Vol. 27, No. 1. pp. 32-36.
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