J Korean Neurosurg Soc.  2009 Nov;46(5):501-504. 10.3340/jkns.2009.46.5.501.

Remote Cerebellar Hemorrhage after Lumbar Spinal Surgery

• Nam TK
• Park SW
• Min BK
• Hwang SN

• KMID: 2190085
• DOI: http://doi.org/10.3340/jkns.2009.46.5.501

Abstract

Remote cerebellar hemorrhage (RCH) is rare but potentially lethal as a complication of spinal surgery. We recently experienced a case of RCH in a 61-year-old man who showed mental deterioration after lumbar spinal surgery. There was dural tearing with subsequent cerebrospinal fluid (CSF) loss during the surgery. Brain computed tomography scan revealed cerebellar hemorrhage, 3rd and 4th ventricular hemorrhage and pneumocephalus. He underwent suboccipital craniectomy and hematoma removal. The most important pathomechanism leading to RCH after spinal surgery has been known to be venous bleeding due to caudal sagging of cerebellum by rapid leak of large amount of CSF which seems to be related with this case. Dural repair and minimizing CSF loss after intraoperative dural tearing would be helpful to prevent postoperative RCH.

Keyword

Remote cerebellar hemorrhage; Spinal surgery; Dural tear; Cerebrospinal fluid leakage

MeSH Terms

Brain
Cerebellum
Hematoma
Hemorrhage
Humans
Middle Aged
Pneumocephalus