Abstract
Remote cerebellar hemorrhage after supratentorial surgery is rare, ranging between 0.08% and 0.29% in adults and children. However, it is extremely rare in children. This phenomenon underlying mechanisms remain obscure. A 14-year-old male child patient had a history of right focal seizures and underwent craniotomy for a left frontal mass (Dysembryoplastic Neuroepithelial Tumor). First hours post recovery period, the patient was somnolent and had right hemiparesis. Postoperative Computer Tomography and magnetic resonance imaging findings revealed that the patient had developed remote cerebellar hemorrhage. He was treated conservatively, and was free of neurological deficits.Although dehydration and the displacement of the cerebellum are associated with this phenomenon after supratentorial surgery, the identification of the exact etiological factors remains elusive. It is advisable for case givers to be aware of the high potential risk of morbidity and mortality of this entity. Preoperative attention to prevent cerebrospinal fluid overflow leakage and exaggerated dehydration of the patient may prevent remote cerebellar hemorrhages.
Highlights
Hemorrhage in the area of the operative site is a well known complication of cranial surgery
Remote cerebellar hematoma after supratentorial craniotomy is most common between the ages of 30 and 60 years [3]
This phenomenon is rare in children [5]. It was reported rare incidences ranging between 0.08 and 0.29% [6].We found only 6 cases of pediatric remote cerebellar hemorrhage complicating supratentorial craniotomy in literature (Table 1)
Summary
Hemorrhage in the area of the operative site is a well known complication of cranial surgery. Cases Journal 2009, 2:7299 http://casesjournal.com/casesjournal/article/view/7299 occurred following resection of Dysembryoplastic neuroepithelial tumor on the left frontal site, is extremely rare and an unusual complication in children Case presentation This 14-year-old Turkish male patient from Azerbaijan had a history of right focal seizures that began when he was 3 years of age. His previous examination and therapy was significant in that he experienced episodes of focal seizure until 6 years of age He was treated with antiepileptic medicine (Phenobarbital), and a cranial MR image showed a left frontal mass. A CT scan of the patient’s head was obtained on postoperative day five and revealed a significant decrease in the cerebral and cerebellar edema, the previous surgery cavity reappeared and the cerebellar hematoma resembled the immediate postoperative brain CT He required two antiepileptic combination treatments (Lamostrigine and phenytoin sodium). He was discharged at day eight postoperatively, his postoperative follow-up history revealed that the patient had no seizure activity, and a neurologic examination was conducted on 12th postoperative month
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
