It may be more important than absolute hematoma size for prognosis. Generally speaking, the more lateral the hemorrhage and the smaller the hematoma, the more likely the brainstem structures are spared and the better the prognosis. Brainstem compression and destruction from an expanding mass in the posterior fossa is a common and feared complication. In US population studies, CH is more common in blacks than in other races. Onset of symptoms is generally abrupt.
Presentation varies greatly, depending on the size and location of the hemorrhage.
Some patients are alert and cooperative, while others are in a coma. Signs generally are of abrupt onset and may change suddenly with progressive expansion of hematoma. Signs tend to cluster with level of consciousness. According to van der Hoop et al, lateralizing cerebellar signs may be present in a patient who is alert enough to cooperate with examination. Causes are similar to those of other types of intracranial hemorrhage.