Lim Cheryl Hui Shan, Salkade Parag Ratnakar, Peter Assimta Cynthia
Department of Radiology, Sengkang General Hospital, Singapore, Singapore.
J Radiol Case Rep. 2020 Feb 29;14(2):1-11. doi: 10.3941/jrcr.v14i2.3844. eCollection 2020 Feb.
Remote cerebellar hemorrhage (RCH) is a rare yet potentially fatal complication of supratentorial and spinal surgery, where there has been either intentional or accidental breach of the dura. We present a case of RCH following a L4-5 decompression laminectomy complicated by an intraoperative dural tear which was detected and repaired at the time of surgery. Despite prompt intra-operative repair of the dura, there was persistent cerebrospinal fluid leak as evidenced by a high subfascial epidural drain output which resulted in bilateral intraparenchymal cerebellar hemorrhage. The patient was managed conservatively and recovered without neurological deficits.
远隔性小脑出血(RCH)是幕上和脊柱手术罕见但可能致命的并发症,手术中硬脑膜有意或意外破裂时可发生。我们报告1例L4-5减压椎板切除术后发生RCH的病例,术中并发硬脑膜撕裂,手术时发现并进行了修复。尽管术中及时修复了硬脑膜,但仍有持续性脑脊液漏,表现为筋膜下硬膜外引流管引流量高,导致双侧脑实质内小脑出血。患者接受保守治疗,康复后无神经功能缺损。