Remote cerebellar hemorrhage after lumbar spinal surgery

Cevik, Belma; Kırbaş, İsmail; Çakır, Banu; Akın, Kayıhan; Tekşam, Mehmet

doi:10.1016/j.ejrad.2008.01.004

Cited by 46 publications

(37 citation statements)

References 10 publications

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“…1,2,4-6,8-12,14-18,24-28,38,39 An incidence rate of less than 0.8% has been attributed to CBH after lumbar spine surgery, 6 which is close to the 0.6% incidence rate associated with remote CBH after craniotomy.…”

Section: Discussionmentioning

confidence: 81%

“…17 Such findings support this sagmodel hypothesis, in which a decrease in CSF volume or pressure causes the brain to descend, resulting in stretching and therefore tearing of the cerebral and cerebellar veins. 3,6,7,11,15,35,37 Further neurological decline may occur through caudal displacement of the cerebellum with brainstem compression and development of cranial neuropathies, as described by Gul et al…”

Section: Discussionmentioning

confidence: 99%

“…6,11 The etiology of remote ICH remains unclear, but evidence suggests that it is caused by excessive CSF loss, which results in cerebral dehydration causing stretching and eventually tearing of the bridging veins. The postoperative hemorrhage may be classified as cerebellar hemorrhage (CBH), subarachnoid hemorrhage (SAH), subdural hemorrhage (SDH), or intraventricular hemorrhage (IVH).…”

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confidence: 99%

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Intracranial hemorrhage after spine surgery

Kaloostian

Kim

Bydon

et al. 2013

SPI

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Object. The authors describe the largest case series of 8 patients with intracranial hemorrhage (ICH) after spinal surgery and identify associated pre-, intra-, and postoperative risk factors in relation to outcome.Methods. The authors retrospectively reviewed the cases of 8 patients treated over 16 years at a single institution and also reviewed the existing literature and collected demographic, treatment, and outcome information from 33 unique cases of remote ICH after spinal surgery.Results. The risk factors most correlated with ICH postoperatively were the presence of a CSF leak intraoperatively and the use of drains postoperatively with moderate hourly serosanguineous output in the early postoperative period.Conclusions. Intracranial hemorrhage is a rare complication of spinal surgery that is associated with CSF leakage and use of drains postoperatively, with moderate serosanguinous output. These associations do not justify a complete avoidance of drains in patients with CSF leakage but may guide the treating physician to keep in mind drain output and timing of drain removal, while noting any changes in neurological examination status in the meantime. Additionally, continued and worsening neurological symptoms after spinal surgery may warrant cranial imaging to rule out intracranial hemorrhage, usually within the first 24 hours after surgery. The presence of cerebellar hemorrhage and hydrocephalus indicated a trend toward worse outcome. (http://thejns.org/doi/abs/10.3171/2013.6.SPINE12863) KEy WorDs • intracranial hemorrhage • spine surgery • cerebrospinal fluid leakAbbreviations used in this paper: CBH = cerebellar hemorrhage; ICH = intracranial hemorrhage; IVH = intraventricular hemorrhage; SAH = subarachnoid hemorrhage; SDH = subdural hemorrhage.

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Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Intracranial hemorrhage after spine surgery

Kaloostian

Kim

Bydon

et al. 2013

SPI

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“…Como se puede observar en la Tabla 1, en la que se resumen las características de los casos publicados, todos los pacientes sufrieron desgarro dural, excepto en dos en que no se hace referencia 5 , el cual se objetivo durante la intervención o se descubrió a posteriori. Esto convierte a la fístula de LCR en el factor causal fundamental para la aparición de estos hematomas.…”

Section: Discussionunclassified

Hematoma cerebeloso como complicación de artrodesis lumbar: A propósito de un caso y revisión de la literatura

Castle¹,

Barrena²,

Samprón³

et al. 2011

Neurocirugía

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ResumenEl hematoma cerebeloso (HCD) como complicación en cirugía de raquis, es menos frecuente que el hematoma a distancia secundario a la cirugía intracraneal. Se manifiesta principalmente con cefalea o deterioro del nivel de consciencia y se ha asociado a la pérdida de LCR intra o postoperatoria.Presentamos un caso de HCD en una paciente de 55 años tras cirugía instrumentada de columna lumbar con fístula de LCR oculta, además de una revisión de la literatura con análisis de sus posibles causas, así como las implicaciones terapéuticas.PALABRAS CLAVE. Hematoma cerebeloso a distancia. Cirugía de raquis. Fístula de LCR. Remote cerebellar haemorrhage after lumbar arthrodesis: Case report and literature review SummaryRemote cerebellar haemorrhage (RCH) is a rare complication of spinal surgery, less frequent than the RCH observed after an intracranial surgery. The patients principally complained of headache or were presented with deterioration in mental status.We report a case of RCH in a 55 years old woman that underwent lumbar arthrodesis with occult dural defect. We review the literature, analysing its causes and therapeutic implications.KEY WORDS. Remote cerebellar haemorrhage. Spinal surgery. Cerebrospinal fluid leakage.

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“…Hemorrhage after cranial or spinal surgery can occur in the intracerebral, cerebellar, epidural, or subdural compartments. A previous study reported that the incidence of RCH in lumbar spine surgery is 0.08% 10) , but a report by Morofuji suggests that the incidence is likely to be higher 11) . There are numerous reports of patients in whom RCH developed as a delayed complication of spinal surgery 5,12-16) .…”

Section: Discussion Discussion Discussionmentioning

confidence: 99%

Incidence of Remote Cerebellar Hemorrhage in Patients with a Dural Tear during Spinal Surgery: A Retrospective Observational Analysis

Wada

Yui

Tamaki

et al. 2019

Spine Surg Relat Res

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Introduction: The incidence of remote cerebellar hemorrhage (RCH) in patients with a dural tear during spinal surgery is unclear. The purpose of this study was to determine the incidence of RCH and the causative factors in these patients.Methods: Two hundred and thirty-nine patients underwent spinal surgery at our institution between March 2015 and September 2016. Eleven of these patients needed dural suturing intraoperatively. All patients underwent CT of the head on the first postoperative day and were categorized according to whether they had RCH or not. The mean values for the amount of intraoperative bleeding, maximum perioperative blood pressure, postoperative drainage volume, and complaints of headache during the first 24 h postoperatively were compared between the two groups using the Welch's two-sample t-test and Fisher's exact test. The follow-up duration was 12 months.Results: There were four patients in the RCH group and seven in the non-RCH group. The incidence of RCH was 36.4%. There were three cerebellar hemorrhages and one interhemispheric fissure hemorrhage in the RCH group. The mean intraoperative bleeding volume was 284 mL in the RCH group and 569 mL in the non-RCH group. The mean respective values for maximum perioperative blood pressure and postoperative drainage volume were 132 mmHg and 547 mL in the RCH group and 144 mmHg and 567 mL in the non-RCH group; none of the differences was statistically significant. However, complaints of headache in the first 24 h postoperatively were significantly more common in the RCH group than in the non-RCH group (100% vs. 14.3%; p = 0.01). All patients with intracranial bleeding had recovered 3 months after surgery.Conclusions: The incidence of RCH following a dural tear during spinal surgery was 36.4%. There was a significant association between RCH and increased reporting of headache during the first 24 h postoperatively.

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Remote cerebellar hemorrhage after lumbar spinal surgery

Cited by 46 publications

References 10 publications

Intracranial hemorrhage after spine surgery

Intracranial hemorrhage after spine surgery

Hematoma cerebeloso como complicación de artrodesis lumbar: A propósito de un caso y revisión de la literatura

Incidence of Remote Cerebellar Hemorrhage in Patients with a Dural Tear during Spinal Surgery: A Retrospective Observational Analysis

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