Supratentorial space occupying lesions following infratentorial surgery early diagnosis and treatment

Abstract

Supratentorial complications of infratentorial surgery are rare. In the last 3 years we have operated on 187 patients with infratentorial lesions and have observed an incidence of 3.7% of supratentorial haemorrhages. Postoperative intracranial air, as shown by early postoperative CT control, was encountered mainly in a subdural frontal location and within the interhemispheric fissure. We performed no surgical decompression of the air accumulation because of the lack of clinical symptoms. Predisposing factors for the development of supratentorial complications remote from the surgical area are hypertonia, female sex, brain atrophy and preoperative shunting procedures. Measures to avoid these complications are discussed.

Pneumocephalus and tension pneumocephalus after posterior fossa surgery in the sitting position: A prospective study

“…These data confirm the findings of Harders etal. 6. On the other hand, a certain degree of drowsiness and confusion without focal deficit was observed in two patients with significant pneumocephalus.…”

“…On rare occasions these advantages can be offset by several adverse effects, some of which are serious and potentially fatal, such as air embolism, postural hypotension and intracerebral haemorrhage remote from the operative site s, 6,29 A further complication of the sitting position has been identified in recent years, namely the large intracranial accumulation of air under pressure, i.e., tension pneumocephalus, which results in progressive obtundation, with or without lateralizing signs 3, 7, 9, 10, 12--14, 19, 21 In practice, however, the incidence of pneumocephalus after craniotomy with the patient in the sitting position, and the subsequent development, if any, of tension pneumocephalus and its pathogenesis has yet to be assessed. The present study therefore has a twofold aim: on the one hand, to evaluate the true incidence of pneumocephalus after craniotomy with the patient in the sitting position and, on the other, to discuss the underlying mechanism and the predisposing factors involved in its progression towards tension pneumocephalus.…”

Cerebellar haemorrhage as a complication after supratentorial craniotomy

“…Remote intracerebral haemorrhage secondary to neurosurgical operation was reported after posterior fossa surgery 16,17,34,38. A definite aetiology was seldom found.…”

Remote Supratentorial Hemorrhage After Posterior Fossa Surgery: A Brief Case Report

“…Reports in the literature on this rare complication, evidence cases where the hematoma was presented in hours to days. (3,4,5,6,7,8,9,10). To our knowledge this is the first report in the literature of supratentorial hemorrhage and posterior fossa surgery one month after the surgical procedure has been performed.…”