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Journal of Korean Neurosurgical Society 2009;46(5): 501-504.
doi: https://doi.org/10.3340/jkns.2009.46.5.501
Remote Cerebellar Hemorrhage after Lumbar Spinal Surgery.
Taek Kyun Nam, Seung Won Park, Byung Kook Min, Sung Nam Hwang
Department of Neurosurgery, Chung-Ang University Yongsan Hospital, Seoul, Korea. nspsw@cau.ac.kr
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.
Key Words: Remote cerebellar hemorrhage; Spinal surgery; Dural tear; Cerebrospinal fluid leakage
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