Remote cerebellar haemorrhage

A remote cerebellar haemorrhage is a relatively benign and extremely rare complication of supratentorial craniotomy or spinal surgery 1-2.  It is called remote as the cause is far from the location of the haemorrhage. 

Most patients are asymptomatic 2. When symptomatic, delayed awakening from anaesthesia and reduced level of consciousness are the frequently reported symptoms. It often tends to have a self-limiting course. 

It has been postulated that post-surgical CSF hypovolaemia causes cerebellar sagging and occlusion of superior penetrating veins and hence haemorrhagic infarction. The exact pathophysiology, however, is not clear yet.


The most common radiologic finding is layering of blood over superior folia "zebra sign" 6,7 and less frequently it could be an intraparenchymal or lobar haemorrhage. Cerebellar haemorrhage could be contralateral or ipsilateral to the site of surgery and sometimes on both sides or even could be isolated to the vermis. The right clinical setting is invaluable for image interpretation.

Share article

Article Information

rID: 10167
Synonyms or Alternate Spellings:
  • Remote cerebellar hemorrhage
  • Remote cerebellar haemorrhage
  • RCH

Support Radiopaedia and see fewer ads

Cases and Figures

  • Drag
    Case 1
    Drag here to reorder.
  • Updating… Please wait.

    Alert accept

    Error Unable to process the form. Check for errors and try again.

    Alert accept Thank you for updating your details.