Clinical Course

Background and Purpose Because the timing and strategy of surgical intervention in massive cerebellar infarction re-mains controversial, we report our experience with the man-agement of 52 such patients. Methods Case records, computed tomographic scans, sur-gical reports, and angiograms of 52 patients with space-occupying cerebellar infarction defined by computed tomo-graphic criteria were reevaluated with regard to clinical course, etiology, therapeutic management, mortality, and functional outcome. Results In most cases clinical deterioration started on the third day after stroke, and a comatose state was reached within 24 hours. Sixteen patients were treated medically, and 30 by suboccipital craniectomy (22 plus ventriculostomy, 12 plus tonsillectomy). Ten patients primarily had ventriculostomy