Presentation
Headache and cerebellar signs day 7 post spinal surgery with CSF leak.
Patient Data
bilateral, left greater than right, hematoma along the superior folia of the cerebellum
no hydrocephalus or tonsilar herniation
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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