Türk Nöroşirürji Dergisi 2010 , Vol 20 , Num 3
Remote Cerebellar Hemorrhages after Supratentorial and Spinal Surgery: Report of Two Cases
Berker CEMİL1, Fatih KIRAR2, Emre Cemal GÖKÇE3, Mehmet TEKŞAM4, Bülent ERDOĞAN5
1,2,5Fatih Üniversitesi, Tıp Fakültesi Hastanesi, Beyin ve Sinir Cerrahisi Anabilim Dalı, Ankara, Türkiye
3Beytepe Asker Hastanesi, Beyin ve Sinir Cerrahisi Kliniği, Ankara, Türkiye
4Fatih Üniversitesi, Tıp Fakültesi Hastanesi, Radyodiagnostik Anabilim Dalı, Ankara, Türkiye
Hemorrhage of cerebellum remote from surgical site of spinal surgery and supratentorial craniotomy is a very infrequent and unpredictable complication in neurosurgical practice. Clinical symptoms of remote cerebellar hemorrhage are often mild and transient. One of our patients developed cerebellar hemorrhage in the left hemisphere after left fronto-orbito-zygomatic craniotomy. The other patient developed cerebellar hemorrhage in the vermis and bilateral hemispheres after T12–L2 laminectomy with the patient in the prone position, during which the dura mater was opened for tumor excision. Both of patients were treated conservatively and the second one had mild residual dysarthria and gait ataxia 6 months after surgery. Cerebellar hemorrhage must be considered in patients with unexplained neurological deterioration after spinal surgery and supratentorial craniotomy. The most important pathomechanism leading to remote cerebellar hemorrhage after spinal surgery and supratentorial craniotomy has been known to be venous bleeding due to caudal sagging of cerebellum by rapid leak of large amount of cerebro spinal fluid which seems to be related in our two cases. Minimizing cerebro spinal fluid loss during surgery would be helpful to prevent postoperative remote cerebellar hemorrhage. Anahtar Kelimeler : Cerebellum, Hemorrhage, Spinal surgery, Supratentorial craniotomy