Remote Cerebellar Hemorrhage due to Cerebrospinal Fluid Leakage or Meningitis after Spinal Surgery: Case Report.
10.4184/jkss.2016.23.1.31
- Author:
Sang Hun KO
1
;
Jae Ryong CHA
;
Hang Ki KANG
;
Sung Do CHO
;
Kwang Hwan JUNG
;
Chae Chil LEE
;
Yun Suck YEOM
;
Sang Woo KIM
Author Information
1. Department of Orthopedic Surgery, Ulsan University Hospital, College of Medicine, Ulsan University, Korea. jrcha@uuh.ulsan.kr
- Publication Type:Case Report
- Keywords:
Complication;
Spinal surgery;
Remote cerebellar hemorrhage;
Cerebrospinal fluid;
Dural tear;
Meningitis
- MeSH:
Aged;
Brain;
Cerebrospinal Fluid*;
Decompression;
Dizziness;
Edema;
Headache;
Hemorrhage*;
Humans;
Magnetic Resonance Imaging;
Meningitis*;
Spinal Stenosis;
Tears
- From:Journal of Korean Society of Spine Surgery
2016;23(1):31-35
- CountryRepublic of Korea
- Language:English
-
Abstract:
STUDY DESIGN: A case report. OBJECTIVES: To report a rare case of remote cerebellar hemorrhage (RCH) as a complication of spinal surgery. SUMMARY OF LITERATURE REVIEW: Remote cerebellar hemorrhage is rare but lethal as a complication of spinal surgery. Interestingly, dural tears and cerebrospinal fluid (CSF) leakage are reported in all published cases of RCH. MATERIALS AND METHODS: A 67-year-old man had posterior lumbar decompression and posterolateral fusion for spinal stenosis at L4/5/S1. Intraoperatively, the dura was torn and there was a loss of CSF. The dural tear was sutured immediately in a water-tight manner. After surgery, the patient complained of headache and dizziness. On postoperative day 44, brain magnetic resonance imaging (MRI) showed meningeal enhancement suggesting meningitis. On postoperative day 54, brain computed tomography (CT) showed cerebellar edema and hemorrhage, and external ventricular derivation was performed. RESULTS: The patient died. CONCLUSIONS: Special attention should be paid to prevent dural damage during spinal surgery or minimize CSF leakage in the case of dural damage and tears during spinal surgery, and CT and MRI should be promptly performed for symptomatic patients.
