Remote cerebellar hemorrhage

Case contributed by Dr Matthew Lukies

Presentation

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

Patient Data

Age: 70 years
Gender: Female
CT
  • Bilateral, left greater than right, hematoma along the superior folia of the cerebellum
  • No hydrocephalus or tonsilar herniation
MRI
  • Bilateral, left greater than right, intra-axial hematoma along the superior folia of the cerebellum and overlying streaks of subarachnoid hemorrhage
  • Small hemorrhage also shown in the superior cerebellar vermis
  • Streaks of subarachnoid hemorrhage over the left temporal and bilateral occipital sulci, likely redistribution
  • No underlying enhancing mass lesions shown

Case Discussion

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

 

Thanks to Dr George Harisis.

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Case information

rID: 73998
Published: 31st Jan 2020
Last edited: 17th Jun 2020
Inclusion in quiz mode: Included

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