Sato Shinsuke, Hayashi Hiroshi, Urayama Daiki, Ito Yusuke, Naganuma Hidetoshi, Shinbori Hiroshi
Department of Orthopedic Surgery, Ibaraki Prefectural Central Hospital, Kasama Shi, Ibaraki Ken, 309 1703, Japan.
J Orthop Case Rep. 2023 Sep;13(9):38-41. doi: 10.13107/jocr.2023.v13.i09.3868.
Remote cerebellar hemorrhage (RCH) has been reported as a serious complication of spine surgery and is considered to be caused by dural injury. However, we have experienced a case in which intracranial hemorrhage occurred immediately after lumbar spine surgery without dural tear. There were no reports of RCH in spinal surgery without dural injury as far as we could find.
We described a rare presentation of an 80-year-old male who suffered a loss of consciousness after lumbar surgery. He was diagnosed with impaired consciousness due to chronic and acute intracranial hemorrhage. He went through two hematoma removal surgeries and his consciousness improved.
RCH can occur in spinal surgery in patients with predicted cerebrovascular fragility, even in the absence of dural injury. Pre-operative imaging evaluation could be useful in assessing cerebrovascular fragility.
远程小脑出血（RCH）已被报道为脊柱手术的一种严重并发症，被认为是由硬脑膜损伤引起的。然而，我们遇到过一例腰椎手术后立即发生颅内出血但无硬脑膜撕裂的病例。据我们所知，尚无关于无硬脑膜损伤的脊柱手术中发生RCH的报道。
我们描述了一名80岁男性在腰椎手术后出现意识丧失的罕见病例。他被诊断为因慢性和急性颅内出血导致意识障碍。他接受了两次血肿清除手术，意识有所改善。
即使在没有硬脑膜损伤的情况下，预测有脑血管脆弱性的患者在脊柱手术中也可能发生RCH。术前影像学评估可能有助于评估脑血管脆弱性。
