Supratentorial hematoma during infratentorial surgery: A short series of three cases

Abstract

Distant site hematoma formation may complicate an otherwise uneventful surgery. The authors describe three cases of such unexpected complications, while operating upon infratentorial lesions in prone position. Pathophysiology behind such complications and changes in intraoperative monitoring is discussed, along with all the previously reported cases. Of the three cases, there was one death, while rest of the two cases made eventless recovery. Meticulous hemostasis, isolation of operative site, avoidance of cerebrospinal fluid over-drainage during surgery may prevent such a complication. Careful interpretation of vital-monitoring may indicate the occurrence of such a complication.

Key words

Distant site hematoma - posterior fossa surgery - prone position

• References

• 1 Tjan TG, Aarts NJ. Bifrontal epidural haematoma after shunt operation and posterior fossa exploration: Report of a case with survival. Neuroradiology 1980; 19: 51-53
• 2 Suzuki S, Saitoh K, Iwabuchi T, Hayashi A. Bilateral supratentorial epidural haematomas occurring independently and consecutively after the removal of a craniospinal meningioma. Acta Neurochir (Wien) 1982; 65: 61-66
• 3 Chandra PS, Jaiswal A, Mahapatra AK. Bifrontal epidural haematomas following surgery for occipital falcine meningioma: An unusual complication of surgery in the prone position. J Clin Neurosci 2002; 9: 582-584
• 4 Porto L, Kieslich M, Turowski B, Lanfermann H, Zanella FE. Spinal subdural haematoma mimicking tethered cord after posterior fossa open surgery. Neuroradiology 2002; 44: 415-417
• 5 Wolfsberger S, Gruber A, Czech T. Multiple supratentorial epidural haematomas after posterior fossa surgery. Neurosurg Rev 2004; 27: 128-132
• 6 Hicdonmez T, Kilincer C, Hamamcioglu MK, Cobanoglu S. Paraplegia due to spinal subdural hematoma as a complication of posterior fossa surgery: Case report and review of the literature. Clin Neurol Neurosurg 2006; Sep 108 (06) 590-594