Spontaneous cerebellar hemorrhage etiology
Etiologies are similar to ICH of any location; however, some nuances:
1. Hypertension is a factor in up to two-thirds of cerebellar hemorrhages
2. Cerebellar Arteriovenous Malformation is a consideration, an aneurysm is very rare (possibly AICA aneurysm, but usually only in association with other high-flow lesions, e.g. AVM)
3. may be related to recent previous spinal or supratentorial surgery
Hypertensive cerebellar hemorrhage may be the first presentation of underlying tumor, specifically cerebellar glioblastoma multiforme. Patients undergoing surgery for cerebellar hemorrhage should have clot specimens sent for histologic examination and have pre- and postcontrast MRIs. Patients not undergoing surgery should have MRIs done after hematoma resolution to rule out underlying tumor 1).
Cerebellar hemorrhage from Cerebellar Arteriovenous Malformation