Remote cerebellar hemorrhage: A case report

Omer, Adil; Engelman, Ester; Bath, Khushbir; Krauthamer, Alan V.; Pisinski, Leszek

doi:10.1016/j.radcr.2018.12.006

Cited by 2 publications

(1 citation statement)

References 14 publications

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“…Remote cerebellar hemorrhage (RCH) is an unusual complication of supratentorial or spinal operations, with an incidence being 0.08%-0.6% [ 1 , 2 ]. It is well-documented that head rotation, cerebrospinal drainage, and the use of antiplatelet or anticoagulation drugs can cause RCH [ 1 – 3 ]. Other conditions associated with RCH include postoperative unruptured aneurysm and spinal surgery [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Remote cerebellar hemorrhage following repeated lumbar punctures

Wang

Han

et al. 2023

BMC Neurol

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Background Remote cerebellar hemorrhage (RCH) is a rare complication in neurosurgery. No case of RCH secondary to repeated lumbar punctures (LPs) has been previously reported. Case presentation A 49-year-old man presented with impaired consciousness following persistent fever. Cerebrospinal fluid examination showed high opening pressure, elevated white blood cells, increased protein level, and decreased glucose level, resulting in a diagnosis of bacterial meningoencephalitis. Treatment with repeated LPs and intrathecal injection of ceftriaxone resulted in an improvement in neurological symptoms. However, on day 31 of treatment, brain magnetic resonance image (MRI) showed streaky bleeding in bilateral cerebellum (zebra sign), leading to a diagnosis of RCH. Close observation and repeated brain MRI imaging without specific treatments led to the absorption of bilateral cerebellar hemorrhage, and the patient was discharged with improved neurological symptoms. Repeated brain MRI scans one month after discharge showed that bilateral cerebellar hemorrhage had improved, and had disappeared one year after discharge. Conclusion We reported a rare occurrence of LPs-induced RCH presenting as isolated bilateral inferior cerebellar hemorrhage. Clinicians should be vigilant of the risk factors for RCH, closely monitoring patients' clinical symptoms and neuroimaging findings to determine the need for specialized treatment. Furthermore, this case highlights the importance of ensuring the safety of LPs and managing any potential complications appropriately.

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