Remote cerebellar hemorrhage following thoracic spinal surgery of an intradural extramedullary tumor: a case report

Journal of Medical Case Reports

Yoichi Shimada¹  Toshiki Abe²  Eiji Abe²  Naohisa Miyakoshi¹  Takashi Kobayashi²  Masazumi Suzuki² 

[1] Department of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita 010-8543, Japan;Department of Orthopedic Surgery, Akita Kousei Medical Center, 1-1-1 Iijima, Nishifukuro 011-0948, Akita, Japan

关键词: Neurological signs;    Thoracic spine;    Spinal surgery;    Remote cerebellar hemorrhage;    Intradural extramedullary tumor;    Postoperative complication;   

Others  :  1145633
DOI  :  10.1186/s13256-015-0541-8

 received in 2014-08-22, accepted in 2015-02-03,  发布年份 2015

【 摘 要 】

Introduction

Remote cerebellar hemorrhage is a rare complication of spinal surgery. Although loss of cerebrospinal fluid seems to play an important role in the pathogenesis of this complication, the detailed mechanism of remote cerebellar hemorrhage after spinal surgery remains unclear. We report the case of a patient with remote cerebellar hemorrhage following thoracic spinal surgery of an intradural extramedullary tumor and discuss this entity with reference to the literature.

Case presentation

A 57-year-old Japanese woman presented to our hospital with back pain, dysuria, and numbness of both legs. A neurological examination was performed, and imaging was performed with ordinary radiography, magnetic resonance imaging, and computed tomography. Her magnetic resonance imaging scan showed an intradural extramedullary tumor at the T3 level. A tumor resection and T1-T5 pedicle screw fixation were performed. Twelve hours after spinal surgery, she complained of unexpected dizziness, nausea, and vomiting. A total of 850mL of serosanguineous fluid had been drained at that time, and drainage was stopped. An urgent brain computed tomography scan showed a cerebellar hemorrhage. She was treated conservatively, and was able to leave hospital six weeks after the initial operation, without any neurological deficits except for slight ataxia.

Conclusions

Remote cerebellar hemorrhage has to be suspected when unexpected neurological signs occur after spinal surgery. If an excessive amount of cerebrospinal fluid drains from the drainage tube after spinal surgery, drainage should be stopped.

【 授权许可】

   
2015 Suzuki et al.; licensee BioMed Central.

【 图 表 】

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