title: Multiple spinal hemangioblastomas complicated with postoperative remote cerebellar hemorrhage: review of the literature of two rare entities.
abstract: BACKGROUND
  Multiple spinal hemangioblastomas constitute a rare pathology; most patients have von Hippel-Lindau disease. In the literature, spinal surgery has been complicated with remote intracranial hemorrhage in a very few cases.
  
  
  METHODS
  A 51-year-old woman, with no pertinent familial past medical history, presented with low back pain. Medullary magnetic resonance imaging revealed 3 spinal extramedullary tumors. The tumor at the L4 level appeared as a dumbbell-shaped neurinoma-like mass with enlarged vessels nearby. Medullary angiography excluded a dural fistula. Surgery was performed in 2 stages for all lesions. The day after lumbar surgery, the patient became comatose because of a remote cerebellar hemorrhage associated with hydrocephalus. She underwent external ventricular drainage and posterior fossa craniectomy.
  
  
  RESULTS
  The patient recovered fully at 35 days except for a slight disorientation and diplopia. Histology of all lesions revealed hemangioblastomas. Discussion of this case concerns radiologic features of spinal hemangioblastomas, diagnosis of von Hippel-Lindau disease, and pathophysiology of hemorrhagic complications following spinal surgery.
  
  
  CONCLUSIONS
  This case report includes 2 rare entities, of which every spinal surgeon should be aware.
authors.affiliation: Department of Neurosurgery, Fondation Ophtalmologique Rothschild, Paris, France. Electronic address: dorianchauvet@yahoo.fr.
authors.forename: Dorian
authors.initials: D
authors.lastname: Chauvet
authors.affiliation: Department of Neurosurgery, Fondation Ophtalmologique Rothschild, Paris, France.
authors.forename: Bénédicte
authors.initials: B
authors.lastname: Silhouette
authors.affiliation: Intensive Care Unit, Fondation Ophtalmologique Rothschild, Paris, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Engrand
authors.affiliation: Department of Neurosurgery, Fondation Ophtalmologique Rothschild, Paris, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Pradier
authors.affiliation: Department of Interventional Neuroradiology, Fondation Ophtalmologique Rothschild, Paris, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Piotin
authors.affiliation: Department of Neurosurgery, Fondation Ophtalmologique Rothschild, Paris, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Lot
mesh_terms: D002543:Cerebral Hemorrhage / Q000209:etiology* / Q000473:pathology; D005260:Female; D018325:Hemangioblastoma / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D013125:Spinal Neoplasms / Q000473:pathology / Q000601:surgery*; D006623:von Hippel-Lindau Disease / Q000473:pathology / Q000601:surgery*