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Supratentorial Subdural Hemorrhage of a Previous Head Injury and Cerebellar Hemorrhage After Cervical Spinal Surgery: A Case Report and Review of the Literature.
MedLine Citation:
PMID:  24718071     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Study design. Case reportObjective. To report a case of an acute supratentorial subdural hemorrhage (SDH) of a previous head injury site and cerebellar hemorrhage (CH), following an incidental dural tear during spine surgery.Summary of Background Data. Intracranial hemorrhage, such as subdural, cerebellar, subarachnoid and epidural hemorrhage following a dural tear during spinal surgery, is a rare and poorly recognized complication. Moreover, only three cases in patients with concurrent SDH and CH have been described in the literature, and none of these reports demonstrated the bleeding point on the dural adhesion's site at the regions of the previous head injury.Methods. A case report and literature review are presented.Results. A 46-year-old male underwent occipital cervical surgery for os odontoideum. Intraoperatively, a dural tear was noted and repaired, but he later developed postoperative disturbance of consciousness. Head CT revealed a supratentorial SDH and CH. Evacuation of the supratentorial SDH was performed via craniotomy, and the bleeding point was revealed to be on the dural adhesion's site where the patient had experienced a previous head injury. The patient made a full recovery.Conclusion. This report illustrates that cerebrospinal fluid leakage following a dural tear during spinal surgery may cause intracranial hemorrhage. A previous head trauma could be a risk factor for such hemorrhagic complications. Headache, nausea, and postoperative stupor after spinal surgery, especially following an accidental durotomy, should be considered possible indications of intracranial hemorrhage, and affected patients should be investigated with CT or MRI.
Authors:
Tadatsugu Morimoto; Makoto Shiraki; Koji Otani; Motoki Sonohata; Masaaki Mawatari
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-4-8
Journal Detail:
Title:  Spine     Volume:  -     ISSN:  1528-1159     ISO Abbreviation:  Spine     Publication Date:  2014 Apr 
Date Detail:
Created Date:  2014-4-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7610646     Medline TA:  Spine (Phila Pa 1976)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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