title: Multiple supra- and infratentorial intraparenchymal hemorrhages presenting with seizure after massive sacral cerebrospinal fluid drainage.
abstract: METHODS
  Case report and review of the literature.
  
  
  OBJECTIVE
  To describe a case of multiple supra- and infratentorial hemorrhages after spinal surgery presenting with seizure.
  
  
  BACKGROUND
  Cerebrospinal fluid overdrainage is a well-documented factor associated with remote cerebellar hemorrhage, but supratentorial hemorrhages after spinal surgery have been reported rarely.
  
  
  METHODS
  A 64-year-old woman underwent a sacral laminectomy for recurrent chordoma. A negative pressure wound drain was left in after surgery and drained 1300 mL in the first 48 hours. On the fourth postoperative day, the patient presented with tonic-clonic seizures.
  
  
  RESULTS
  Diagnostic imaging showed multiple supra- and infratentorial intraparenchymal hemorrhages and a massive sacral cerebrospinal fluid leak. The patient underwent emergent surgery for a primary repair of the presumed dural defect.
  
  
  CONCLUSIONS
  Patients who present with severe positional headache, altered mental status, or tonic-clonic seizures after undergoing intradural spinal procedures involving massive cerebrospinal fluid loss may be suffering from multiple supra- and infratentorial intracranial hemorrhages.
authors.affiliation: Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, USA.
authors.forename: Christian A
authors.initials: CA
authors.lastname: Bowers
authors.forename: Philipp
authors.initials: P
authors.lastname: Taussky
authors.forename: Bradley S
authors.initials: BS
authors.lastname: Duhon
authors.forename: Meic H
authors.initials: MH
authors.lastname: Schmidt
mesh_terms: D002543:Cerebral Hemorrhage / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D006801:Humans; D020300:Intracranial Hemorrhages / Q000175:diagnosis* / Q000209:etiology; D007796:Laminectomy / Q000009:adverse effects; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D012447:Sacrum / Q000601:surgery; D012640:Seizures / Q000209:etiology / Q000503:physiopathology*; D013353:Subdural Effusion / Q000209:etiology / Q000503:physiopathology*; D014057:Tomography, X-Ray Computed