Korean J Neurotrauma.  2015 Oct;11(2):201-204. 10.13004/kjnt.2015.11.2.201.

Remote Cerebellar Hemorrhage after Surgery for Degenerative Lumbar Spine Disease: A Case Report

• Kim JY
• Kim DK
• Yoon SH

• KMID: 2378288
• DOI: http://doi.org/10.13004/kjnt.2015.11.2.201

Abstract

Spine surgery has been increased as the population ages, but the occurrence of unusual complication such as remote cerebellar hemorrhage (RCH) is not well understood. We recently experienced a case of RCH in a 60-year-old woman showed neurologic dysfunction after degenerative lumbar spine surgery. There was no definite dural tearing and cerebrospinal fluid (CSF) loss during operation. Brain magnetic resonance imaging showed cerebellar hemorrhage. The patient received conservative management and rehabilitation program. Most other reports have been suggested that RCH after spinal surgery might be related with excessive CSF drainage perioperatively. Minimizing of CSF loss during operation would be helpful to reduce the risk of RCH. If large volume of CSF has been lost accompanied by neurologic deterioration, brain imaging is necessary simultaneously.

Keyword

Cerebellar disease; Intracranial hemorrhage; Lumbar vertebrae surgery; Dura mater injury; Cerebrospinal fluid; Postoperative complication

MeSH Terms

Brain
Cerebellar Diseases
Cerebrospinal Fluid
Drainage
Female
Hemorrhage*
Humans
Intracranial Hemorrhages
Magnetic Resonance Imaging
Middle Aged
Neuroimaging
Neurologic Manifestations
Postoperative Complications
Rehabilitation
Spine*
Tears

Figure

• 

  FIGURE 1 A, B: The lumbar spine magnetic resonance imaging shows lumbarization of the S1 vertebra, degenerative spondylolisthesis at L4/5 and retrolisthesis at L5/S1.

• 

  FIGURE 2 Postoperative X-ray (A, B) shows a laminectomy on L4 and L5, with instrumentation from L3 to S1.

• 

  FIGURE 3 Axial plane images of the gradient recalled echo sequence (A) revealed a subacute cerebellar hemorrhage postoperatively. Evidence of an infarction or vascular abnormality could not be found on the magnetic resonance angiography (B).

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