Cerebellar hemorrhage after spine surgery

Hashidate, Hiroyuki; Kamimura, Mikio; Nakagawa, Hiroyuki; Takahara, Kenji; Uchiyama, Shigeharu; Kato, Hiroyuki

doi:10.1007/s00776-007-1199-x

Cited by 25 publications

(29 citation statements)

References 18 publications

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“…Cerebellar ''sag'' which is a result of excessive CSF leakage has been proposed to cause stretching and occlusion of the superior vermian veins. In patients with insufficient venous collaterals, this may cause venous infarction, subsequently leading to hemorrhagic transformation [2,[6][7][8][9][10][11][12][13][14][15] as occurred in our first and second cases. Another explanation is a rise in transmural venous pressure associated with CSF drainage and intracranial hypotension [2].…”

Section: Discussionmentioning

confidence: 99%

“…Spine surgery is linked with a wide range of intraoperative complications including wrong-level surgery, nerve root lesion, vascular injury, and dural tearing [1,2]. Dural tear during spinal surgery is not uncommon, with reported incidence rates of 1-17% [1].…”

Section: Introductionmentioning

confidence: 99%

“…Most common causes of dural tear are thin dura, adhesion of dura, surgical technique, and so on. This complication may cause postural headache, nerve root or brainstem herniation, cerebellar dysfunction, or intracranial hemorrhage [1][2][3][4][5]. Intraoperative cerebrospinal fluid (CSF) loss following dural tear may occur unexpectedly due to reasons such as spine surgery, myelography, ventriculoperitoneal shunt placement, epidural anesthesia, spine trauma, etc.…”

Section: Introductionmentioning

confidence: 99%

“…Subsequent development of intracranial and/or intraspinal hypotension may result in postural headache usually lasting for 5 days, nerve root or brainstem herniation, cerebellar dysfunction, photophobia, mental status alteration, and seizure in affected patients [4]. One of the rare fatal complications following CSF leak is formation of intracranial hematoma in different locations including acute subdural hematoma (SDH), epidural hematoma (EDH), and remote cerebellar hemorrhage (RCH) [1][2][3][4][5].…”

Section: Introductionmentioning

confidence: 99%

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Intracranial hemorrhage following lumbar spine surgery

Khalatbari¹,

Khalatbari²,

Moharamzad³

2012

Eur Spine J

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Background Intracranial hemorrhage is a serious but rare complication of spinal surgery, which can occur in the intracerebral, cerebellar, epidural, or subdural compartment. Purpose To describe patients with intracranial hemorrhage after lumbar spinal surgery and present clinical and diagnostic imaging findings. Methods In this retrospective study, medical records of 1,077 patients who underwent lumbar spinal surgery in our tertiary referral neurosurgery center between January 2003 and September 2010 were studied. The original presentations of the patients before the surgical intervention were herniated lumbar disc, spinal canal stenosis, spondylolisthesis, lumbar spinal trauma, and lumbar spine and epidural tumor. The operations performed consisted of discectomy, multiple level laminectomy, stabilization and fusion, lumbar instrumentation, and lumbar spinal and epidural tumor resection.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Intracranial hemorrhage following lumbar spine surgery

Khalatbari¹,

Khalatbari²,

Moharamzad³

2012

Eur Spine J

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“…Since then, eight more cases of patients with cerebellar haematoma after spinal operations have been published [5 (2 cases), 7,8,12,14,20,21].…”

Section: Discussionmentioning

confidence: 99%

Remote intracranial parenchymal haematomas as complications of spinal surgery: presentation of three cases with minor or untypical symptoms

Hempelmann¹,

Mater²

2012

Eur Spine J

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Introduction Intracranial haemorrhage is a rare complication of spinal surgery. Three cases of cerebral or cerebellar haemorrhages following spinal operations with CSF loss are reported, and the literature was reviewed. Case presentations One patient suffered from melancholy after the operation, one patient had moderate headache and nausea, and the third patient suffered from mental confusion and anxiety. The intracranial haemorrhages were treated conservatively. All patients recovered from the bleedings. Results The cases show that cerebral or cerebellar haemorrhage after spinal CSF loss may be accompanied by minor or rather untypical clinical symptoms. Conclusion The dangerous complication of intracranial haemorrhage has to be kept in mind when patients have moderate cerebral symptoms after CSF loss due to spinal operations.

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Remote cerebellar haemorrhage after lumbar spine surgery: case report

Cavanilles-Walker

Tomasi

Sgier

et al. 2013

Arch Orthop Trauma Surg

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Remote cerebellar haemorrhage (RCH) is a well-described complication of supratentorial surgical procedures with an incidence ranging between 0.2 and 4.9 %, but is a rare complication of spinal surgery. We report a case of RCH in a 65-year-old woman who showed sudden mental deterioration 48 h after lumbar spinal surgery, which was complicated by incidental dural tearing with minimal CSF loss. Brain CT scan revealed hypodense areas compatible with acute infarction involving mostly the left cerebellar hemisphere. No cerebral bleeding was observed. MRI was also performed revealing small cerebellar areas of acute infarction mainly relating the vermis and the left postero-inferior cerebellar hemisphere with haemorrhagic transformation and mass effect in the posterior fossa producing acute hydrocephalus. Haematoma removal was initially attempted by means of a suboccipital craniotomy. An external ventricular derivation was placed in a second procedure 24 h later due to the persistence of ventricular dilatation. At discharge the patient was only showing a slight dysmetria with the fine motor skills of hands and fingers. All cases of RCH after spinal surgery reported in the literature are invariably associated to iatrogenic dural tearing; although CSF loss seems to play the key role in the pathogenesis of this rare complication, the exact pathophysiology of this condition still remains undetermined.

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Cerebellar hemorrhage after spine surgery

Cited by 25 publications

References 18 publications

Intracranial hemorrhage following lumbar spine surgery

Intracranial hemorrhage following lumbar spine surgery

Remote intracranial parenchymal haematomas as complications of spinal surgery: presentation of three cases with minor or untypical symptoms

Remote cerebellar haemorrhage after lumbar spine surgery: case report

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