Brain Tumor Res Treat.  2015 Oct;3(2):141-146. 10.14791/btrt.2015.3.2.141.

Remote Cerebellar Infarction after Supratentorial Craniotomy and Its Management: Two Case Reports

• Yoon SJ
• Hong CK

• KMID: 2114663
• DOI: http://doi.org/10.14791/btrt.2015.3.2.141

Abstract

The cerebellar infarction resulting from supratentorial craniotomy is uncommon event and its management has been controversial. After removal of space occupying lesion on right frontal area, two cases of remote cerebellar infarctions occurred. We reviewed each cases and the techniques to manage such complications are discussed. Early extraventricular catheter insertion and midline suboccipital craniectomy were effectively performed in obtunded patients from cerebellar infarction.

Keyword

Brain infarction; Cerebellum; Cerebrovascular circulation; Postoperative complications

MeSH Terms

Brain Infarction
Catheters
Cerebellum
Cerebrovascular Circulation
Craniotomy*
Humans
Infarction*
Postoperative Complications

Figure

• 

  Fig. 1 Neuroimaging studies. A: MRI, contrast enhancing mass in the right frontal area. B: Digital subtraction angiography, there were no right vertebral artery injection images, and the PICA territory was not evaluated for feeder vessels. C: Gliolan fluorescent intraoperative image showing a red glowing mass inside a cavity. D: Postoperative CT, bilateral PICA territorial infarction accompanying acute hydrocephalus. E: Postoperative CT, decreased ventricle size after insertion of the EVD. F: CT, midline suboccipital craniectomy. PICA, posterior inferior cerebellar artery; EVD, extraventricular drainage.

• 

  Fig. 2 Neuroimaging studies. A: MR, a brain tumor in the right frontal parasagittal area. B: Digital subtraction angiography, hypervascular tumor with feeder vessels from the anterior cerebral artery. C: Intraoperative imaging of the tumor shows engorged vessels around the mass. D: Postoperative MR scan showing bilateral PICA and AICA territory infarctions. E: Postoperative CT with decreased ventricle size after insertion of the EVD. F: CT, swollen cerebellum compressing the brain stem. AICA, anterior inferior cerebellar artery; PICA, posterior inferior cerebellar artery; EVD, extraventricular drainage.

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