{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T06:40:20Z","timestamp":1776321620874,"version":"3.50.1"},"reference-count":15,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2021,3,2]],"date-time":"2021-03-02T00:00:00Z","timestamp":1614643200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,3,2]],"date-time":"2021-03-02T00:00:00Z","timestamp":1614643200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Neurocrit Care"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>In patients with spontaneous cerebellar intracerebral hemorrhage (ICH) guidelines advocate evacuation when the hematoma diameter is &gt;\u20093\u00a0cm. We studied outcome in patients with cerebellar ICH &gt;\u20093\u00a0cm who did not undergo immediate hematoma evacuation.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We included consecutive patients with cerebellar ICH &gt;\u20093\u00a0cm at two academic hospitals between 2008 and 2017. Patients who died &lt;\u200924\u00a0h (h) were excluded because of probable confounding by indication. We determined patient characteristics, hematoma volumes, EVD placement, secondary hematoma evacuation, in-hospital and 3-month case-fatality, and functional outcome.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Of 130 patients with cerebellar ICH, 98 (77%) had a hematoma &gt;\u20093\u00a0cm of whom 22 (23%) died &lt;\u200924\u00a0h and 28 (29%) underwent hematoma evacuation &lt;\u200924\u00a0h. Thus, 48 patients were initially treated conservatively (mean age 70\u2009\u00b1\u200913, 24 (50%) female). Of these 48 patients, 7 (15%) underwent secondary hematoma evacuation &gt;\u200924\u00a0h, of whom 1 (14%) had received an EVD &lt;\u200924\u00a0h. Five others also received an EVD &lt;\u200924\u00a0h without subsequent hematoma evacuation. Of the 41 patients without secondary hematoma evacuation, 11 (28%) died and 20 (51%) had a favorable outcome (mRS of 0\u20133) at 3\u00a0months. The 7 patients who underwent secondary hematoma evacuation had a decrease in GCS score of at least two points prior to surgery; two (29%) had deceased at 3\u00a0months; and 5 (71%) had a good functional outcome (mRS 0\u20133).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>While cerebellar ICH &gt;\u20093\u00a0cm is often considered an indication for immediate hematoma evacuation, there may be a subgroup of patients in whom surgery can be safely deferred. Further data are needed to assess the optimal timing and indications of surgical treatment in these patients.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s12028-021-01203-6","type":"journal-article","created":{"date-parts":[[2021,3,2]],"date-time":"2021-03-02T00:04:42Z","timestamp":1614643482000},"page":"680-686","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Secondary Hematoma Evacuation and Outcome After Initial Conservative Approach for Patients with Cerebellar Hematoma Larger than 3\u00a0cm"],"prefix":"10.1007","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9304-8107","authenticated-orcid":false,"given":"Sanjula D.","family":"Singh","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Floris H. B. 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