Hidden hazard of remote cerebellar hemorrhage after cervical spine surgery: Case report

作者：Barnabas Obeng-Gyasi, Emma Love, Mugtaba Swar-Eldahab, Matthew Blackwell, Anoop S. Chinthala, Gordon Mao · 发表于：International Journal of Surgery Case Reports · 年份：2025 · DOI：10.1016/j.ijscr.2025.111571 · 被引用次数：1 · 研究领域：Neurosurgical Procedures and Complications、Cerebrospinal fluid and hydrocephalus、Head and Neck Surgical Oncology

INTRODUCTION AND IMPORTANCE: Remote cerebellar hemorrhage (RCH) is a rare but potentially serious complication of spinal surgery, particularly after decompressive procedures and instrumented fusion. The complex interplay between cerebrospinal fluid leaks and hemorrhage risk necessitates a high index of suspicion and prompt management to optimize patient outcomes. CASE PRESENTATION: We present a case of RCH in a 50-year-old man with hypertension, non-insulin dependent diabetes mellitus, and cervical myeloradiculopathy following a C3-C6 laminectomy with posterior instrumented fusion. Despite an initially benign presentation, the patient developed severe positional headaches, nausea, vomiting, and lethargy. A head CT on postoperative day five revealed a right cerebellar hemispheric hemorrhage with obstructive hydrocephalus. Intensive care management, including strict blood pressure control, serial neuroimaging, and close neurological monitoring, led to hemorrhage stabilization and discharge on postoperative day 18. CLINICAL DISCUSSION: RCH is believed to result from venous infarction secondary to rapid cerebrospinal fluid loss, often associated with dural tears. Even minor cerebrospinal fluid leaks can precipitate significant complications, underscoring the importance of early recognition and tailored management. Patient positioning and subfascial drainage strategies during surgery should be optimized to mitigate risks, and vigilant postoperative monitoring is critical for timel...