title: Multiple hemorrhages in brain after spine surgery supra- and infra-tentorial components together.
abstract: Remote cerebellar hemorrhage after cranial and spinal surgeries is a well-documented entity, so far concomitant supra- and infra-tentorial hemorrhage after spine surgery has rarely been reported in the literature. A 57-year-old woman presented with intractable low back pain and severely impaired mobility. One year ago, she underwent lumbar laminectomy and fusion with posterior spinal instrumentation between L2 and S1. She developed adjacent segment disease at the upper level of the instrumented vertebra. She had a revision surgery and underwent posterior laminectomy and fusion with bilateral transpedicular instrumentation between T10 and S1. She had severe headache, somnolence, and left hemiparesia 48 h after the surgery. Her emergent head computed tomography depicted intra-parenchymal hemorrhage in the right parietal lobe accompanying with subarachnoid hemorrhage, bilateral symmetrical cerebellar hemorrhages and pneumocephalus. She was treated nonsurgically and she got better despite some residual deficits. Symptoms including constant headache, nausea, vomiting, impaired consciousness, new onset seizure, and focal neurological deficit after spine surgeries should raise suspicion for intracranial intra-parenchymal hemorrhage.
authors.affiliation: Department of Neurosurgery, Medical School, Bahçeşehir University, Istanbul, Turkey.
authors.forename: Baran
authors.initials: B
authors.lastname: Yılmaz
authors.affiliation: Department of Neurosurgery, Hakkari State Hospital, Hakkari, Turkey.
authors.forename: Semra
authors.initials: S
authors.lastname: Işık
authors.affiliation: Department of Orthopaedic Surgery, Spine Center, University of California at San Francisco, CA, USA.
authors.forename: Murat Şakir
authors.initials: MŞ
authors.lastname: Ekşi
authors.affiliation: Department of Orthopaedic Surgery, Spine Center, University of California at San Francisco, CA, USA.
authors.forename: Emel Ece Özcan
authors.initials: EE
authors.lastname: Ekşi
authors.affiliation: Department of Neurosurgery, Medical School, Bahçeşehir University, Istanbul, Turkey.
authors.forename: Akın
authors.initials: A
authors.lastname: Akakın
authors.affiliation: Department of Neurosurgery, Medical School, Bahçeşehir University, Istanbul, Turkey.
authors.forename: Zafer Orkun
authors.initials: ZO
authors.lastname: Toktaş
authors.affiliation: Department of Neurosurgery, Medical School, Bahçeşehir University, Istanbul, Turkey.
authors.forename: Deniz
authors.initials: D
authors.lastname: Konya
keywords: Cerebrospinal fluid; intracranial hemorrhage; spine; surgery