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Remote Cerebellar Hemorrhage due to Cerebrospinal Fluid Leakage or Meningitis after Spinal Surgery - Case Report -

  • Journal of Korean Society of Spine Surgery
  • Abbr : J Kor Spine Sur
  • 2016, 23(1), pp.31-35
  • Publisher : Korean Society Of Spine Surgery
  • Research Area : Medicine and Pharmacy > Orthopedic Surgery

KO, SANG-HUN 1 Jae-Ryong Cha 1 강항기 2 CHO, SUNG-DO 1 Jung, Kwang-Hwan 1 Lee, Chae-Chil 1 Youm, Yoon-Seok 1 김상우 1

1울산대학교
2울산대학교 의과대학 울산대학교병원 정형외과학교실

Accredited

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.

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