Conservative versus surgical treatment in the management of cerebellar infarction: A meta-analysis.

BACKGROUND: Recent guidelines do not clearly favor either conservative or surgical treatment for cerebellar infarction. We aim to compare the clinical outcomes of these 2 treatments in patients with cerebellar infarcts through meta-analysis. METHODS: We systematically searched 4 databases - PubMed, Cochrane Library, Embase, and Web of Science - from inception to May 1, 2024 to identify eligible studies that compared surgical treatment and conservative treatment. Two authors independently extracted data on mortality, modified Rankin Scale, and Glasgow outcome scale for patients with cerebellar infarction. RESULTS: We retrieved 12 eligible studies, including 1108 participants. No significant differences were observed in terms of mortality, modified Rankin Scale, acute cerebellar infarction between the 2 treatments. However, there was a statistically significant difference between surgery and no-surgery group regarding serious adverse outcomes with a Glasgow outcome scale score of 2 to 4, including moderate recovery, severe disability, persistent vegetative state (odds ratio: 2.14; 95% confidence interval: 1.05-4.36; P = .04; I2 = 0%), and in the consciousness dysfunction group (odds ratio: 0.32; 95% confidence interval: 0.12-0.88; P = .03; I2 = 64%). CONCLUSION: This meta-analysis of cohort studies indicated that surgery led to more serious adverse outcomes for patients with cerebellar infarction compared to conservative treatment, but showed more favorable outcomes for patients with consciousness dysfunction during follow-up. Further research is warranted to explore these aspects in depth.