Lefranc F, De Witte O, David P, Brotchi J
Département de Neurochirurgie, Hôpital Erasme-ULB, Bruxelles (Belgique).
Neurochirurgie. 2000 Sep;46(4):395-7.
Postoperative cerebellar hemorrhage after a supratentorial craniotomy represents a rare event. We report a case of a patient with a meningioma of the jugum who developed suddenly after surgery a neurological deterioration due to a cerebellar hemorrhage detected on the CT scan. An occipital craniectomy and an external ventricular drainage were performed in emergency. A complete neurological recovery was observed after surgery. Nineteen similar other cases are found in the literature. Pre- and postoperative high blood pressure, lowered intracranial pressure and mispositioning of the head during surgery could be at the origin of the hemorrhage. Size of the hemorrhage, time between diagnosis and treatment represent two prognostic factors. All patients, who present a neurological deterioration in postoperative course, must have CT scan including posterior fossa.
幕上开颅术后发生小脑出血是一种罕见事件。我们报告一例蝶骨嵴脑膜瘤患者,术后因CT扫描发现小脑出血而突然出现神经功能恶化。紧急情况下进行了枕下颅骨切除术和脑室外引流。术后观察到神经功能完全恢复。文献中还发现了19例类似病例。术前和术后的高血压、颅内压降低以及手术过程中头部位置不当可能是出血的原因。出血大小、诊断与治疗之间的时间是两个预后因素。所有在术后病程中出现神经功能恶化的患者都必须进行包括后颅窝的CT扫描。