A 60-year-old man with previous episodes of ataxia, diplopia, and dizziness, now presents with sudden headache and altered sensorium. The diagnosis is
(B) Cerebellar haemorrhage # Cerebellar Hemorrhage:> Result from the same causes as other intracerebral hemorrhages. Long-standing hypertension with degenerative changes in the vessel walls and subsequent rupture is believed to be the most common cause of a typical cerebellar hemorrhage.> Hemorrhage into tumor, blood dyscrasias, amyloid angiopathy, arteriovenous malformations, trauma, and sympathomimetic abuse are less common causes of CH.> Onset of symptoms is generally abrupt.> Presentation varies greatly, depending on the size and location of the hemorrhage. Some patients are alert with headache and perhaps vomiting; others may be unresponsive with impaired or absent brainstem reflexes.> Following symptoms are roughly in descending order of incidence: Headache of abrupt onset Nausea and vomiting Inability to walk (reflecting truncal ataxia) Dizziness, vertigo Dysarthria Nuchal pain Loss or alteration of consciousness Pontine haemorrhage> Acute haemorrhage within the pons causing a characteristic clinical picture.> Patient complains of a severe headache and rapidly becomes unconscious, and then develops periodic respiration, pinpoint pupils, loss of "doll's head" ocular movements and tetraplegia. There is no flaccidity and the patient may rapidly go into decerebrate posturing.> Hypertension is the main cause of pontine haematoma. CT is the first examination of choice and shows the hyperintense haematoma usually occupying a large part of the pons, sometimes with intraventricular rupture within the first ventricle. There is usually no need for MR or angiography, unless a vascular malformation is suspected
Pontine haemorrhage
Cerebellar haemorrhage
Subdural haemorrhage
Alcoholism
Miscellaneous