Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Remote Cerebellar Hemorrhage Presenting with Cerebellar Mutism after Spinal Surgery : An Unusual Case Report

  • Sen, Halil Murat (Department of Neurology, Faculty of Medicine, Canakkale Onsekiz Mart University) ;
  • Guven, Mustafa (Department of Neurosurgery, Faculty of Medicine, Canakkale Onsekiz Mart University) ;
  • Aras, Adem Bozkurt (Department of Neurosurgery, Faculty of Medicine, Canakkale Onsekiz Mart University) ;
  • Cosar, Murat (Department of Neurosurgery, Faculty of Medicine, Canakkale Onsekiz Mart University)
  • Received : 2014.09.12
  • Accepted : 2015.01.05
  • Published : 2017.05.01
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Abstract

Dural injury during spinal surgery can subsequently give rise to a remote cerebellar hemorrhage (RCH). Although the incidence of such injury is low, the resulting hemorrhage can be life threatening. The mechanism underlying the formation of the hemorrhage is not known, but it is mostly thought to develop after venous infarction. Cerebellar mutism (CM) is a frequent complication of posterior fossa operations in children, but it is rarely seen in adults. The development of CM after an RCH has not been described. We describe the case of a 65-year old female who lost cerebrospinal fluid after inadvertent opening of the dura during surgery. Computerized tomography performed when the patient became unable to speak revealed a bilateral cerebellar hemorrhage.

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References

  1. Afshar-Oromieh A, Linhart H, Podlesek D, Schrempf W, Schackert G, Krex D : Postoperative cerebellar mutism in adult patients with Lhermitte-Duclos disease. Neurosurg Rev 33 : 401-408, 2010 https://doi.org/10.1007/s10143-010-0278-1
  2. Cavanilles-Walker JM, Tomasi SO, Sgier F, Krober M : Remote cerebellar haemorrhage after lumbar spine surgery : case report. Arch Orthop Trauma Surg 133 : 1645-1648, 2013 https://doi.org/10.1007/s00402-013-1867-6
  3. Cevik B, Kirbas I, Cakir B, Akin K, Teksam M : Remote cerebellar hemorrhage after lumbar spinal surgery. Eur J Radiol 70 : 7-9, 2009 https://doi.org/10.1016/j.ejrad.2008.01.004
  4. Chadduck WM : Cerebellar hemorrhage complicating cervical laminectomy. Neurosurgery 9 : 185-189, 1981 https://doi.org/10.1227/00006123-198108000-00016
  5. Dincer A, Ozcan U, Kaya D, Usseli MI, Erzen C, Pamir MN : Asymptomatic remote cerebellar hemorrhage : CT and MRI findings. Cerebellum 11 : 880-886, 2012 https://doi.org/10.1007/s12311-011-0351-5
  6. Dubey A, Sung WS, Shaya M, Patwardhan R, Willis B, Smith D, et al. : Complications of posterior cranial fossa surgery--an institutional experience of 500 patients. Surg Neurol 72 : 369-375, 2009 https://doi.org/10.1016/j.surneu.2009.04.001
  7. Friedman JA, Ecker RD, Piepgras DG, Duke DA : Cerebellar hemorrhage after spinal surgery : report of two cases and literature review. Neurosurgery 50 : 1361-1363; discussion 1363-1364, 2002
  8. Hashidate H, Kamimura M, Nakagawa H, Takahara K, Uchiyama S, Kato H : Cerebellar hemorrhage after spine surgery. J Orthop Sci 13 : 150-154, 2008 https://doi.org/10.1007/s00776-007-1199-x
  9. Konya D, Ozgen S, Pamir MN : Cerebellar hemorrhage after spinal surgery : case report and review of the literature. Eur Spine J 15 : 95-99, 2006 https://doi.org/10.1007/s00586-005-0987-2
  10. Lee HY, Kim SH, So KY : Seizure and delayed emergence from anesthesia resulting from remote cerebellar hemorrhage after lumbar spine surgery -a case report-. Korean J Anesthesiol 63 : 270-273, 2012 https://doi.org/10.4097/kjae.2012.63.3.270
  11. Nam TK, Park SW, Min BK, Hwang SN : Remote cerebellar hemorrhage after lumbar spinal surgery. J Korean Neurosurg Soc 46 : 501-504, 2009 https://doi.org/10.3340/jkns.2009.46.5.501
  12. Robertson PL, Muraszko KM, Holmes EJ, Sposto R, Packer RJ, Gajjar A, et al. : Incidence and severity of postoperative cerebellar mutism syndrome in children with medulloblastoma : a prospective study by the Children's Oncology Group. J Neurosurg 105(6 Suppl) : 444-451, 2006
  13. Tafazal SI, Sell PJ : Incidental durotomy in lumbar spine surgery : incidence and management. Eur Spine J 14 : 287-290, 2005 https://doi.org/10.1007/s00586-004-0821-2
  14. Wells EM, Walsh KS, Khademian ZP, Keating RF, Packer RJ : The cerebellar mutism syndrome and its relation to cerebellar cognitive function and the cerebellar cognitive affective disorder. Dev Disabil Res Rev 14 : 221-228, 2008 https://doi.org/10.1002/ddrr.25
  15. Yoo JC, Choi JJ, Lee DW, Lee S : Remote cerebellar hemorrhage after intradural disc surgery. J Korean Neurosurg Soc 53 : 118-120, 2013 https://doi.org/10.3340/jkns.2013.53.2.118

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