title: Remote cerebellar hemorrhage after lumbar spinal surgery.
abstract: BACKGROUND
  Postoperative remote cerebellar hemorrhage (RCH) as a complication of lumbar spinal surgery is an increasingly recognized clinical entity. The aim of this study was to determine the incidence of RCH after lumbar spinal surgery and to describe diagnostic imaging findings of RCH.
  
  
  METHODS
  Between October 1996 and March 2007, 2444 patients who had undergone lumbar spinal surgery were included in the study. Thirty-seven of 2444 patients were scanned by CT or MRI due to neurologic symptoms within the first 7 days of postoperative period. The data of all the patients were studied with regard to the following variables: incidence of RCH after lumbar spinal surgery, gender and age, coagulation parameters, history of previous arterial hypertension, and position of lumbar spinal surgery.
  
  
  RESULTS
  The retrospective study led to the identification of two patients who had RCH after lumbar spinal surgery. Of 37 patients who had neurologic symptoms, 29 patients were women and 8 patients were men. CT and MRI showed subarachnoid hemorrhage in the folia of bilateral cerebellar hemispheres in both patients with RCH. The incidence of RCH was 0.08% among patients who underwent lumbar spinal surgery.
  
  
  CONCLUSIONS
  RCH is a rare complication of lumbar spinal surgery, self-limiting phenomenon that should not be mistaken for more ominous pathologic findings such as hemorrhagic infarction. This type of bleeding is thought to occur secondary to venous infarction, but the exact pathogenetic mechanism is unknown. CT or MRI allowed immediate diagnosis of this complication and guided conservative management.
authors.affiliation: Baskent University Faculty of Medicine, Department of Radiology, Fevzi Cakmak Cad. 10. sok. No: 45, Bahcelievler, Ankara 06490, Turkey. belmac@baskent-ank.edu.tr
authors.forename: Belma
authors.initials: B
authors.lastname: Cevik
authors.forename: Ismail
authors.initials: I
authors.lastname: Kirbas
authors.forename: Banu
authors.initials: B
authors.lastname: Cakir
authors.forename: Kayihan
authors.initials: K
authors.lastname: Akin
authors.forename: Mehmet
authors.initials: M
authors.lastname: Teksam
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020201:Brain Hemorrhage, Traumatic / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007796:Laminectomy / Q000706:statistics & numerical data*; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology*; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D014421:Turkey; D055815:Young Adult