Remote cerebellar hemorrhage (RCH) is a rare complication after supratentorial or spinal surgery. RCH is poorly known and hence probably underdiagnosed. Diminished consciousness and headache are the most common clinical features. Computed tomography and magnetic resonance reveal a characteristic pattern of linear bleeding between the cerebellar folia. The pathophysiological mechanism is disputed but is probably venous bleeding secondary to significant intraoperative or postoperative loss of cerebrospinal fluid. Multiple risk factors have been described, but postsurgical negative pressure drainage of cerebrospinal fluid is the only clearly predisposing factor. We present a case of RCH after spinal surgery with a literature review.

Paget's disease is a common entity but osteosarcoma arising in Paget's disease is an infrequent complication. Primary osteosarcomas are typically long bone tumours and the skull is rarely affected. A case with malignant transformation of Paget's disease of the skull and an unusual clinical presentation is reported. Computed tomography scans of the tumour area show interesting results. Main features are: an intensive sclerotic reaction of the host bone, an inner and outer spiculation of the calvarium, radial ossifications in the soft extracranial mass, and spotty calcifications and ossifications of the osteosarcomatous portion infiltrating the brain.