Posterior fossa hemorrhage after supratentorial surgery.
OBJECTIVE
To evaluate the imaging findings, possible pathogenesis, and frequency of hemorrhage near the tentorial surface of the cerebellum after supratentorial surgery.


METHODS
Over a 5-year period, 13 patients with posterior fossa hemorrhage after supratentorial surgery were identified with postoperative CT studies, which were obtained in all patients after craniotomy. Four of the 13 patients also had postoperative MR examinations. Preoperative and postoperative radiologic studies and medical records were reviewed.


RESULTS
All hemorrhages were located along the superior aspect of the cerebellum transversely oriented along the cerebellar fossa and fissures. None of the patients had coagulopathy or radiologic evidence of posterior fossa tumor or vascular malformation. None of the hemorrhages had an appearance typical of hypertensive hemorrhage. Ten patients (77%) had lumbar drains placed before surgery and all had epidural drains placed at the conclusion of surgery. One patient had surgery for a meningioma, and 12 had surgery for aneurysms. The frequency of hemorrhage after aneurysmal surgery was 3.5%. No neurologic deficits developed referable to the cerebellum.


CONCLUSIONS
Hemorrhage should be viewed as a potentially benign sequela of surgery rather than as an indication of hypertension, aneurysm, or previously unrecognized vascular malformation or neoplasm.
Cloft
H J
HJ
Department of Radiology, University of Virginia Health Sciences Center, Charlottesville 22908, USA.
Matsumoto
J A
JA
Lanzino
G
G
Cail
W S
WS
D000328:Adult; D000368:Aged; D002526:Cerebellar Diseases / Q000175:diagnosis*; D002543:Cerebral Hemorrhage / Q000175:diagnosis*; D003388:Cranial Fossa, Posterior / Q000473:pathology; D003399:Craniotomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000175:diagnosis / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008577:Meningeal Neoplasms / Q000175:diagnosis / Q000601:surgery*; D008579:Meningioma / Q000175:diagnosis / Q000601:surgery*; D008875:Middle Aged; D009460:Neurologic Examination; D019106:Postoperative Hemorrhage / Q000175:diagnosis*; D011379:Prognosis; D014057:Tomography, X-Ray Computed