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Remote control: intradural spinal tumour resection complicated by remote cerebellar haemorrhage
EANS Academy. Khan A. 09/25/19; 275574; EP02082
Amad Khan
Amad Khan

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Abstract
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Introduction: Remote cerebellar haemorrhage (RCH) is a rare, potentially lethal, neurosurgical complication. It is defined when posterior fossa haemorrhage occurs distant from the anatomical location of surgery. It is a recognised complication of supratentorial craniotomy and more uncommonly following spinal surgery. Incidence reported in the literature following supratentorial surgery varies from 0.2% to 4.9%. All cases reported following decompressive spinal surgery were associated with dural tear. The literature does not offer incidence rates in intradural tumour resective surgery where dural opening is a necessary procedure. The pathophysiological aetiology is likely shared in both circumstances, although the exact mechanism is still unknown.
Methods: A case report and review of the literature.
Results: We report a case of RCH following spinal intradural schwannoma resection in light of the review of the current literature. The 69 year-old patient underwent elective L5/S1 laminectomy in prone position under general anaesthetic with microscopic resection of the intradural lesion and a drain was eft in situ. Histopathology confirmed WHO grade 1 schwannoma. There were no intra-operative or immediate peri-operative complications. The patient awoke normally from anaesthesia. On post-operative day 1, he developed headache and subsequent drowsiness. CT head showed left cerebellar haemorrhage with surrounding oedema. Therefore, he underwent posterior fossa craniectomy and evacuation of the intracerebellar haematoma. He made a steady subsequent recovery on the ward and was discharged home once well.
Conclusion: RCH is a rare complication following spinal surgery, involving dural opening. The authors would like to highlight this condition for consideration as a cause of unexplained neurological deterioration following spinal surgery.
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