Remote Cerebellar Hemorrhage After Supratentorial Aneurysm Surgery: Report of 2 Cases

Kim, Se Hun; Lee, Ho Kook; Moon, Jae Gon; Kim, Chang Hyun; Choi, Jong Hun

Abstract

Remote cerebellar hemorrhage is a rare complication of supratentorial neurosurgical surgery occurring in approximately 0.3~0.6%, and it is same with the supratentorial aneurysm surgery. Although remote cerebellar hemorrhage is a rare complication of supratentorial neurosurgical surgery, this is often related with significant morbidity and mortality. In spite of its lethal character, the precise mechanism is uncertain. In this article, we present clinical details of two patients with cerebellar hemorrhage after supratentorial aneurysm surgery, and discuss about possible mechanism of this rare complication. In reported articles, seven predisposing factors are correlated with remote cerebellar hemorrhage after supratentorial aneurysm surgery; hypertension, cerebrovasular anomaly, anti-coagulation treatment, coagulopathy, head positioning during surgery, over drainage via epidural closed drainage system with negative pressure, and excessive CSF drainage during or after the surgery. By reporting these two cases, we want to alert neurosurgeons about this rare but lethal complication, and tell about that there are several ways to minimize the possibility of remote cerebellar hemorrhage.