Remote cerebellar haemorrhage

Case contributed by Matthew Lukies
Diagnosis almost certain

Presentation

Headache and cerebellar signs day 7 post spinal surgery with CSF leak.

Patient Data

Age: 70 years
Gender: Female
  • bilateral, left greater than right, haematoma along the superior folia of the cerebellum

  • no hydrocephalus or tonsilar herniation

mri
  • bilateral, left greater than right, intra-axial haematoma along the superior folia of the cerebellum and overlying streaks of subarachnoid haemorrhage

  • small haemorrhage also shown in the superior cerebellar vermis

  • streaks of subarachnoid haemorrhage over the left temporal and bilateral occipital sulci, likely redistribution

  • no underlying enhancing mass lesions shown

Case Discussion

Remote cerebellar haemorrhage is a rare complication of spinal surgery, where it is postulated that CSF hypovolaemia causes traction on the bridging veins leading to haemorrhage. The course is typically benign and managed conservatively.

 

Thanks to Dr George Harisis.

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