Cerebellar haemorrhage with herniation

Case contributed by A.Prof Frank Gaillard

Presentation

Post cardiac ablation.

Patient Data

Age: 65 years

There is a large right cerebellar lobe intraparenchymal haemorrhage associated with extension into the fourth ventricle. There is a degree of downward cerebellar tonsillar herniation and upward transtentorial herniation, effacement of the basal cisterns and compression of the brain stem. The temporal horns are distended. The cerebral sulci are not effaced.

Case Discussion

In this setting, one should consider whether an underlying lesion is present. Given the recent cardiac intervention which almost certainly required intravenous heparinisation, it is likely that this is a primary haemorrhage. 

The patient had the clot urgently evacuated. Followup and MRI (not shown) failed to demonstrate an underlying cause.  

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Case information

rID: 56726
Published: 26th Feb 2018
Last edited: 26th Feb 2018
Inclusion in quiz mode: Included

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