title: [Remote cerebellar hemorrhage after single burr hole drainage of chronic subdural hematoma of the elderly].
abstract: Remote cerebellar hemorrhage is a usual complication after supratentorial craniotomy. Especially, only several cases have been reported regarding the occurrence of remote cerebellar hemorrhage after burr hole drainage for the treatment of chronic subdural hematoma (CSDH). In this paper, we present an elder patient with this rare postoperative complication. A 73-year-old man presented with dysarthria and right hemiparesis. Computed tomography (CT) demonstrated a left chronic subdural hematoma. Hematoma drainage through a single burr hole was perfomed. About 3 hours after the surgery, the patient became restless and presented nausea and dizziness with a relatively large amount of drainage of hematoma. CT revealed resolution of the subdural hematoma and bilateral cerebellar hemorrhage appearing as "zebra sign". Magnetic resonance angiography and 3D-CT angiography showed the normal structure of posterior circulation in both the arterial and venous phases. The remote cerebellar hemorrhage was suspected to have happened as a result of overdrainage of hematoma. Finally, he was discharged without any neurological deficits. Although remote cerebellar hemorrhage after drainage through a burr hole for the treatment of chronic subdural hematoma is a rare complication, it is necessary to be aware of the possibility of such a complication after supratentorial surgery.
authors.affiliation: Department of Surgical Neurology and Stroke Science, Research Institute for Brain and Blood Vessels-Akita, Senshu-Kubota-machi, Akita-city, Akita, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Kobayashi
authors.forename: Tatsushi
authors.initials: T
authors.lastname: Mutoh
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Ishikawa
authors.forename: Junta
authors.initials: J
authors.lastname: Moroi
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Tamagawa
authors.forename: Shotaroh
authors.initials: S
authors.lastname: Yoshioka
authors.forename: Kentaro
authors.initials: K
authors.lastname: Hikichi
authors.forename: Akifumi
authors.initials: A
authors.lastname: Suzuki
mesh_terms: D000368:Aged; D001921:Brain / Q000601:surgery; D002526:Cerebellar Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology*; D002908:Chronic Disease; D004322:Drainage / Q000009:adverse effects*; D006408:Hematoma, Subdural / Q000601:surgery*; D006801:Humans; D008297:Male; D011183:Postoperative Complications; D014057:Tomography, X-Ray Computed