J Korean Neurotraumatol Soc.  2010 Dec;6(2):162-164. 10.13004/jknts.2010.6.2.162.

Remote Cerebellar Hemorrhage after Spinal Surgery

Affiliations
  • 1Deparment of Neurosurgery, Inha University Hospital, School of Medicine, Inha University, Incheon, Korea. nspco@inha.ac.kr

Abstract

This report details a case of a 56-year-old woman who presented with a herniated lumbar disc at L4-5 with congenital spondylolisthesis (grade II) and developed remote cerebellar hemorrhage following an iatrogenic acute reduction in cerebrospinal fluid (CSF) pressure during spinal interbody fusion. Possible mechanisms are discussed: however, pathological events leading to this complication are unclear. Intracranial hemorrhage (ICH) must be considered in patient presenting with unexplained neurological deterioration not attributable to the spinal surgery, especially when the dura has been opened followed by significant CSF loss.

Keyword

Cerebellar hemorrhage; Spinal surgery; Cerebrospinal fluid

MeSH Terms

Female
Hemorrhage
Humans
Intracranial Hemorrhages
Spondylolisthesis

Figure

  • FIGURE 1 Sagittal T1-weighted MR image (A) and T2-weighted MR image (B) show spondylolisthesis (grade II) with herniated disc at L4-5 level. Whole lumbar vertebral body shows the fat marrow change on T1- and T2-weighted MRI.

  • FIGURE 2 Axial CT scan obtained 45 hours after lumbar surgery, reveals large intracerebellar hemorrhage (central to right) with a streaky, curvilinear bleeding pattern in the cerebellar sulci (arrow).

  • FIGURE 3 CT angiography shows no specific abnormal vascular lesion.


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