Browse > Article
http://dx.doi.org/10.3340/jkns.2009.46.2.136

Remote Cerebellar Hemorrhage Complicated after Supratentorial Surgery: Retrospective Study with Review of Articles  

Park, Jae-Suk (Department of Neurosurgery, Kyungpook National University School of Medicine)
Hwang, Jeong-Hyun (Department of Neurosurgery, Kyungpook National University School of Medicine)
Park, Jae-Chan (Department of Neurosurgery, Kyungpook National University School of Medicine)
Hamm, In-Suk (Department of Neurosurgery, Kyungpook National University School of Medicine)
Park, Yeun-Mook (Department of Neurosurgery, Kyungpook National University School of Medicine)
Publication Information
Journal of Korean Neurosurgical Society / v.46, no.2, 2009 , pp. 136-143 More about this Journal
Abstract
Objective: Remote cerebellar hemorrhage (RCH) is one of the rare complications occurring after supratentorial surgery, and its pathomechanism is poorly understood. We report 10 cases of RCH from our institution and review 154 cases from a database in order to delineate incidence, common presentation, risk factors, and outcomes of this complication. In addition, the means of prevention are discussed. Methods: We reviewed the medical records of 10 patients who experienced RCH after undergoing supratentorial surgery at our institution between 2001 and 2008. A database search in Medline revealed 154 cases of RCH in the English literature. Characteristic features were analyzed and compared. Results: There were 10 cases of RCH among 3307 supratentorial surgery cases, indicating a 0.3% incidence. All patients had characteristic imaging features of RCH, namely a streaky bleeding pattern in the superior folia of the cerebellum. Seven patients had a history of preoperative hypertension. Four cases were related to cerebral aneurysms, and other four developed after the removal of brain tumors. Cerebrospinal fluid (CSF) drainage apparatuses were installed postoperatively in all cases. Outcomes according to modified Rankin scale (mRS) were good in 7 patients, with 1 fatal case. Conclusion: RCH is a rare complication after supratentorial surgery, and the exact etiology still remains uncertain. Hypertension and perioperative loss of CSF seem positively correlated with RCH, but no single risk factor is totally responsible. Patients with RCH should be closely observed to improve their prognosis.
Keywords
Remote cerebellar hemorrhage; Supratentorial surgery; CSF drainage;
Citations & Related Records

Times Cited By Web Of Science : 2  (Related Records In Web of Science)
Times Cited By SCOPUS : 7
연도 인용수 순위
1 Bilginer B, Oguz KK, Akalan N, Spencer DD : Remote cerebellarhemorrhage and iliofemoral vein thrombosis after supratentorialcraniotomy. Neurocrit Care 8 : 283-285, 2008   DOI   ScienceOn
2 Brockmann MA, Nowak G, Reusche E, Russlies M, Petersen D : Zebrasign : cerebellar bleeding pattern characteristic of cerebrospinal fluidloss. Case report. J Neurosurg 102 : 1159-1162, 2005   DOI   ScienceOn
3 Dunne JW, Chakera T, Kermode S : Cerebellar hemorrhage - diagnosisand treatment : a study of 75 consecutive cases. Q J Med 64 : 739-754, 1987
4 Gelfenbeyn M, Vasil’ev S, Krylov V : Cerebellar haemorrhage after supratentorial aneurysm surgery with lumbar drainage. NeurosurgRev 24 : 214-219, 2001   DOI   ScienceOn
5 Jang JW, Joo SP, Kim JH, Kim SH : Remote cerebellar hemorrhageafter supratentorial aneurismal surgery : report of six cases. J KoreanNeurosurg Soc 39 : 370-373, 2006
6 Siu TL, Chandran KN, Siu T : Cerebellar hemorrhage followingsupratentorial craniotomy. J Clin Neurosci 10 : 378-384, 2003   DOI   ScienceOn
7 Srikijvilaikul T, Deesudchit T : Cerebellar hemorrhage after supratentorial surgery for treatment of epilepsy : report of two cases. J MedAssoc Thai 90 : 1221-1224, 2007
8 Toczek MT, Morell MJ, Silverberg GA, Lowe GM : Cerebellarhemorrhage complicating temporal lobectomy. Report of four cases. JNeurosurg 85 : 718-722, 1996   DOI   ScienceOn
9 Tucker A, Miyake H, Tsuji M, Ukita T, Nishihara K : Remote cerebellar hemorrhage after supratentorial unruptured aneurysmal surgery: report of three cases. Neurol Res 29 : 493-499, 2007   DOI   ScienceOn
10 Waga S, Shimosaka S, Sakakura M : Intracerebral hemorrhageremote from the site of the initial neurosurgical procedure. Neurosurgery13 : 662-665, 1983   DOI   PUBMED
11 Tomii M, Nakajima M, Ikeuchi S, Ogawa T, Abe T : [Infratentorialhemorrhage following supratentorial surgery.] No Shinkei Geka 27 :921-925, 1999   PUBMED
12 Amini A, Osborn AG, McCall TD, Couldwell WT : Remotecerebellar hemorrhage. AJNR Am J Neuroradiol 27 : 387-390, 2006   PUBMED
13 Marquardt G, Setzer M Schick U, Seifert V : Cerebellar hemorrhageafter supratentorial craniotomy. Surg Neurol 57 : 241-251; discussion251-252, 2002   DOI   ScienceOn
14 Maruyama T, Ishii K, Isono M, Abe T, Fujiki M, Kobayashi H :Remote cerebellar hemorrhage following supratentorial craniotomy--case report. Neurol Med Chir (Tokyo) 44 : 294-297, 2004   DOI   ScienceOn
15 Papanastassiou V, Kerr R, Adams C : Contralateral cerebellar hemorrhagic infarction after pterional craniotomy : report of five cases andreview of the literature. Neurosurgery 39 : 841-851; discussion 851-852, 1996   DOI   PUBMED
16 Yacubian EM, de Andrade MM, Jorge CL, Valério RM : Cerebellarhemorrhage after supratentorial surgery for treatment of epilepsy :report of three cases. Neurosurgery 45 : 159-162, 1999   DOI   PUBMED
17 Yasagil MG, Yonekawa Y : Results of microsurgical extra-intracranialarterial bypass in the treatment of cerebral ischemia. Neurosurgery 1 :22-24, 1977   DOI   PUBMED
18 Konya D, Ozgen S, Pamir MN : Cerebellar hemorrhage after spinalsurgery : case report and review of the literature. Eur Spine J 15 : 95-99, 2006   DOI   ScienceOn
19 Friedman JA, Piepgras DG, Duke DA, McClelland RL, Bechtle PS,Maher CO, et al. : Remote cerebellar hemorrhage after supratentorialsurgery. Neurosurgery 49 : 1327-1340, 2001   DOI   ScienceOn
20 Miyamoto Y, Nakasu S, Nakasu Y, Handa J : [Postoperative intracerebral hematoma remote from the site of craniotomy.] Neuro MedChir (Tokyo) 25 : 219-222, 1985   DOI   PUBMED
21 Park SJ, Oh SM, Shin DI, Park SH : Remote intracerebral hemorrhage complicating aneurysm surgery. J Korean Neurosurg Soc 28 : 532-40, 1999
22 Kaplan SS, Lauryssen C : Cerebellar hemorrhage after evacuation ofan acute supratentorial subdural haematoma. Br J Neurosurg 13 :329-331, 1999   DOI   ScienceOn
23 Brockmann MA, Groden C : Remote cerebellar hemorrhage : a review. Cerebellum 5 : 64-68, 2006   DOI   ScienceOn
24 Farag E, Abdou A, Riad I, Borsellino SR, Schubert A : Cerebellarhemorrhage caused by cerebrospinal fluid leak after spine surgery.Anesth Analg 100 : 545-546, 2005   DOI   ScienceOn
25 K$\ddot{o}$nig A, Laas R, Herrmann HD : Cerebellar haemorrhage as acomplication after supratentorial craniotomy. Acta Neurochir(Wien) 88 : 104-108, 1987   DOI   ScienceOn
26 Kuroda R, Nakatani J, Akai F, Sato M, Kataoka K, Isaka T, et al. :Remote subarachnoid haemorrhage in the posterior fossa followingsupratentorial surgery. Clinical observation of 6 cases. Acta Neurochir(Wien) 129 : 158-165, 1994   DOI   PUBMED
27 Kang YG, Chung H, Lee SP, Choi KH, Yeo HT, Rhee JK : Remoteintracerebral hematoma after supratentorial graniotomy. J KoreanNeurosurg Soc 25 : 1910-1916,1996
28 Cloft HJ, Matsumoto Ja, Lanzino G, Cail WS : Posterior fossahemorrhage after supratentorial surgery. AJNR Am J Neuroradiol 18 :1573-1580, 1997   PUBMED
29 Honegger J, Zentner J, Spreer J, Carmona H, Schulze-Bonhage A :Cerebellar hemorrhage arising postoperatively as a complication ofsupratentorial surgery : a retrospective study. J Neurosurg 96 : 248-254, 2002   DOI   ScienceOn
30 Ikakura K, Nakazawa S, Kuzuhara M, Nakae S : A case of cerebellarhematoma after supratentorial craniotomy. Kanto J Japanese AssocAcute 9 : 342-344, 1998
31 Yoshida S, Yonekawa Y, Yamashita K, Ihara I, Morooka Y : Cerebellar hemorrhage after supratentorial craniotomy--report of three cases.Neurol Med Chir (Tokyo) 30 : 738-743, 1990   DOI   PUBMED
32 Vogels RLC, Verstegen MJ, van Furth WR : Cerebellar haemorrhage after non-traumatic evacuation of supratentorial chronic subduralhaematoma : report of two cases. Acta Neurochir (Wien) 148 : 993-996, 2006   DOI   ScienceOn
33 Seoane E, Rhoton AL Jr : Compression of the internal jugular vein bythe transverse process of the atlas as the cause of cerebellar hemorrhage after supratentorial craniotomy. Surg Neurol 51 : 500-505, 1999   DOI   ScienceOn
34 Brisman MH, Bederson JB, Sen CN, Germano IM, Moore F, Post K : Intracerebral hemorrhage occurring remote from the craniotomy site. Neurosurgery 39 : 1114-1121; discussion 1121-1122, 1996   DOI   ScienceOn
35 Chadduck WM : Cerebellar hemorrhage complicating cervicallaminectomy. Neurosurgery 9 : 185-189, 1981   DOI   PUBMED
36 Modesti LM, Hodge CH, Barnwell ML : Intracerebral hematomaafter evacuation of chronic extracerebral fluid collections. Neurosurgery10 : 689-693, 1982   DOI   PUBMED
37 Lee JW, Yim MB, Lee JC, Son EI, Kim DW, Kim IH : Intracerebralhemorrhage remote from the site of aneurysm surgery. J KoreanNeurosurg Soc 25 : 834-841, 1996
38 van Calenbergh F, Goffin J, Plets C : Cerebellar hemorrhage complicating supratentorial craniotomy : report of two cases. Surg Neurol40 : 336-338, 1993   DOI   ScienceOn
39 Koller M, Ortler M, Langmayr J, Twerdy K : Posterior-fossa haemorrhageafter supratentorial surgery--report bof three cases and reviewof the literature. Acta Neurochir (Wien) 141 : 587-592, 1999   DOI   ScienceOn