Eur Stroke J. 2026 Jul 6;11(7):aakag073. doi: 10.1093/esj/aakag073.
ABSTRACT
INTRODUCTION: Cerebellar ICH accounts for 5%-10% of spontaneous ICH, yet cerebellar-specific incidence data are sparse and the unselected clinical spectrum and outcomes remain poorly characterised.
PATIENTS AND METHODS: We retrospectively identified all adults (≥18 years) in the catchment area of a Norwegian stroke centre with spontaneous cerebellar ICH between 2009 and 2024, using discharge codes and radiological verification. We calculated crude and age-standardised incidence rates with 95% CIs, and assessed clinical characteristics, functional outcome (mRS) and mortality to 1 year.
RESULTS: Among 129 admissions (median age 75 years; 47% women), 120 were incident cases. Age-standardised incidence was 2.6 per 100,000 person-years (95% CI, 2.1-3.0), rising from 0.3 at < 55 to 21.0 at ≥ 85 years, and remained stable over 16 years (incidence rate ratio 0.97/year; 0.93-1.00). Median haematoma volume was 8.1 mL (mean 11.2 mL); one-third were anticoagulated; 13% underwent neurosurgery. Care limitation was frequent (45%; 64% aged ≥ 75). In-hospital mortality was 31% and 1-year mortality 41%; median time to death was 3 days. At 3 months, 29% achieved functional independence (mRS 0-2), and 36% when restricted to early-phase survivors (>3 days).
DISCUSSION: Compared with tertiary surgical series, this unselected cohort had smaller haematomas and a lower surgical rate. Frequent care limitation in older patients reflects clinical reality outside referral centres.
CONCLUSIONS: Cerebellar ICH is rare, with an age gradient mirroring that of ICH overall. Although prognosis is dominated by early deaths, 1 in 3 acute-phase survivors regain functional independence, indicating that outcome is not uniformly poor.
CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, NCT05378490.
PMID:42406909 | DOI:10.1093/esj/aakag073