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Cerebellar Hemorrhage after Posterior Lumbar Decompression and Interbody Fusion Complicated by Dural Tear - A Case Report -

  • Journal of Korean Society of Spine Surgery
  • Abbr : J Kor Spine Sur
  • 2014, 21(4), pp.182-187
  • Publisher : Korean Society Of Spine Surgery
  • Research Area : Medicine and Pharmacy > Orthopedic Surgery

최병완 1 이상민 2 윤민근 2 MOON MYUNG SANG ORD ID 2

1해운대백병원 척추센타
2제주한라병원 정형외과

Accredited

ABSTRACT

Study Design: A case report. Objectives: To report a rare case of remote cerebellar hemorrhage (RCH), which was a complication after posterior decompression andlumbar interbody fusion (PILF). Summary of Literature Review: Remote cerebellar hemorrhage (RCH) after spinal surgery is a rare complication, and its cause isknown to be due to a loss of cerebral spinal fluid (CSF) through the dural tear. Most of the literature has disclosed that early diagnosisand treatment of RCH is very important in the patient with suspicious symptoms. Materials and Methods: A 57-year-old woman had posterior lumbar decompression and interbody fusion for the severe spinal stenosisat L4-5. During surgery, an accidental dural tear with CSF leakage occurred. The torn dura was sutured. Postoperatively, she developednausea and a severe headache. Hypotension developed at postoperative 2 hours. A brain CT showed RCH. The patient was conservativelymanaged with clamping of the wound drainage. Results: The nausea and severe headache were controlled and normal blood pressure could be maintained without dopamine therapyat postoperative day 2. The patient was discharged without any neurological deficit, and her consciousness was clear at postoperative 2weeks. Conclusions: Persistent postoperative nausea, headache, and hypotension after repair of the torn dura may suggest that the treatingsurgeons pay careful attention due to the possibility of RCH, even though the amount of CSF leakage is small.

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