Impending Hydrocephalus in a acute Cerebellar infarct

Impending Obstructive Hydrocephalus In Cerebellar Stroke
🔴Large Cerebellar infarction: Vomiting, lethargy, dysarthria, upper ext ataxia, bilateral inferomedial gaze deviation, brainstem compression, causinghydrocephalus leading to cardiorespiratory complications, coma & death.

Increase edema causing impaired level of consciousness peaks in 3 d (1-7 days) + absent corneal reflex : ?deteriorating. + new brainstem signs.

👉Common Causes: Tumor, Infection, Stroke, Bleeding.

HOB 30-45 degrees.
Don’t kink the neck.
Strict Euvolemia
3% Hypertonic solution (Na > 145-150 )
If intubated: hyperventilate
Stop anti-platelets if going for surgery
Start Heparin (low dose)?? Inc risk of bleeding or hemorrhagic conversion.
EVD (External Ventricular Drainage)
VP shunt
Decompressive craniotomy

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