Three patients with remote cerebellar hemorrhage following supratentorial cerebrovascular surgery are presented. [ncbi.nlm.nih.gov]

• Falling

  For infratentorial hemorrhages, the GCS has been shown to be a predictor of outcome. [8] However, clear consensus does not exist regarding many patients who fall between these extremes. [emedicine.medscape.com]

  Investigation usually reveals a falling hemoglobin level and a blood stained CSF. These findings seem to result from blood loss in the posterior fossa with forward displacement of the cerebellum and brainstem. [spinalmedicine.com]

  As for the long term functional outcome, Portenoy et al. [ 19 ] found that 55% of patients achieve a good functional recovery after sustaining a hypertensive ICH, a figure that falls to 23% if a recurrence develops [ 16 ]. [jmedicalcasereports.com]

  Her neurologic examination findings were normal, except for falling to the right with tandem gait. After CT, the patient underwent magnetic resonance imaging, which showed an infarct of the medial left lobe of the cerebellum ( Figure 3 ). [jamanetwork.com]

• Hemophilia A

  Acquired hemophilia A (AHA) is an uncommon coagulation disorder caused by the development of autoantibodies against coagulation factor VIII (FVIII). [ncbi.nlm.nih.gov]

  "A meta-analysis of the efficacy and safety of recombinant activated factor VII for patients with acute intracerebral hemorrhage without hemophilia". Journal of Clinical Neuroscience. 17 (6): 685–93. doi : 10.1016/j.jocn.2009.11.020. [en.wikipedia.org]

  Bleeding disorders : hemophilia, sickle cell anemia, DIC, thrombocytopenia. Tumors : highly vascular tumors such as angiomas and metastatic tumors can bleed into the brain tissue. [mayfieldclinic.com]

• Aspiration

  On admission, mean hemorrhage volume was 30.25 mL or 3.7x4.75x3.03 cm, mean GCS was 7.5, initial aspiration drained a mean 24 mL of blood. [ncbi.nlm.nih.gov]

  There may be incriminated multiple risk factors: arterial hypertension, use of antiplatelet medication (Aspenter), CSF aspiration or drainage associated with intracranial hypotension. [degruyter.com]

  Depending on the location of the clot either a craniotomy or a stereotactic aspiration may be performed. Craniotomy involves cutting a hole in the skull with a drill to expose the brain and remove the clot. [mayfieldclinic.com]

  神経内視鏡下血腫除去術 4) (Ib)、 51,52) (IV)、CT fluoroscopy下血腫除去術 53) (IV)、MRI-guided stereotactic aspiration 54) (III)、超音波誘導定位脳手術 55,56) (IV)、頭蓋内圧モニタリングの併用 57) (IV)などである。 まだエビデンスを確認できてはいない。 [minds.jcqhc.or.jp]

• Vomiting

  Such a complication is rare but should be considered after foramen magnum decompression surgery if the patient shows unusual symptoms of repeated vomiting. [ncbi.nlm.nih.gov]

  On examination, he was disclosed mental confusion, repeated vomiting, constricred pupil, horizontal nystagmus, inability to stand, dysarthria and neck stiffness. [jkns.or.kr]

• Nausea

  The patient complained of severe headache and nausea postoperatively. Brain computed tomography obtained 3 days after the surgery demonstrated remote cerebellar hemorrhage and hydrocephalus. [ncbi.nlm.nih.gov]

• Large Fontanel

  fontanel on the first day revealed no abnormality Tentorium and cerebellum ID: /22548.jpg Tentorium and cerebellum ID: /22549.jpg Normal ventricles ID: /22550.jpg Cerebellum ID: /22551.jpg A CT scan showed a tentorial and cerebellar hemorrhage with a [ultrasoundcases.info]

• Cesarean Section

  The incidence of cesarean section and emergent delivery were higher in the non-CHI group, however, this difference was not significant (Table 1 ). [actaneurocomms.biomedcentral.com]

• Headache

  Cerebellar symptoms, and even a late sudden headache after spinal surgery, may be signs of remote cerebellar hemorrhage, which is a rare complication. [ncbi.nlm.nih.gov]

• Ataxia

  The neurological examination showed ataxia, myoclonus and dystonia in the right upper extremity. Brain images demonstrated a hemorrhage in the right cerebellar hemisphere secondary to a cavernous malformation. [ncbi.nlm.nih.gov]

• Dizziness

  The wound was healing well and headache and dizziness also improved. He was discharged from the hospital on the 30 th day. [synapse.koreamed.org]

  Twelve hours after spinal surgery, she complained of unexpected dizziness, nausea, and vomiting. A total of 850 mL of serosanguineous fluid had been drained at that time, and drainage was stopped. [ncbi.nlm.nih.gov]

  They frequently present with headache, nausea and vomiting, dizziness, and a striking difficulty standing or walking. [medlink.com]

• Nystagmus

  Abstract A 63-year-old woman presented with a metastatic focus of papillary thyroid carcinoma in the cerebellopontine angle manifesting as lateral gazing nystagmus and slurred speech. [ncbi.nlm.nih.gov]

  Cerebellar signs (e.g. ataxia, nystagmus) 1. Larger bleeds can impair consciousness and obstruct the fourth ventricle resulting in obstructive hydrocephalus. [radiopaedia.org]

  On examination, he was disclosed mental confusion, repeated vomiting, constricred pupil, horizontal nystagmus, inability to stand, dysarthria and neck stiffness. [jkns.or.kr]

• Dysarthria

  The first patient was treated conservatively and had mild residual dysarthria and gait ataxia 2 months after surgery. The second patient underwent exploration and revision of the lumbar wound with primary dural repair. [ncbi.nlm.nih.gov]

  On examination, he was disclosed mental confusion, repeated vomiting, constricred pupil, horizontal nystagmus, inability to stand, dysarthria and neck stiffness. [jkns.or.kr]

  Most prominent feature of acute cerebellar stroke is repeated vomiting Patient will experience occipital headache, vertigo, difficulty remaining upright, walking Most cases show mild unilateral facial weakness and decreased corneal reflex May exhibit dysarthria [accessphysiotherapy.mhmedical.com]

This case series will hopefully shed further light on the incidence, presentation, workup, and treatment of this particular complication of supratentorial surgery. [nebraska.pure.elsevier.com]

In patients with remote site bleed, workup of complete coagulation profile before surgical intervention is highly warranted, Decision to evacuate remote site hematoma should be tailored based on clinical, radiological, and coagulation profile. [neurologyindia.com]

Preoperative identification and workup of the coagulation abnormality is essential to guide initial treatment. In our study, ETV was performed in one patient as an alternative procedure where the intact CSF pathways were emphasized. [tdj.eg.net]

Treatment consisted in external ventricular drainage in case 1 and conservative treatment in case 2. Both patients recovered without major neurological deficits. [ncbi.nlm.nih.gov]

This case series will hopefully shed further light on the incidence, presentation, workup, and treatment of this particular complication of supratentorial surgery. [nebraska.pure.elsevier.com]

Prognosis depends largely on the severity of this bleeding. [ncbi.nlm.nih.gov]

Treatment and prognosis Unlike pontine hemorrhages, cerebellar hemorrhages carry a relatively good prognosis if timely evacuation and control of hydrocephalus can be obtained. Prompt diagnosis and neurosurgical referral are therefore key. [radiopaedia.org]

The first patient was asymptomatic and had a good prognosis, however, the second one was symptomatic and demonstrated deterioration and had a poor prognosis. [surgicalneurologyint.com]

Investigation for etiology of the hemorrhage included an MRI showing extensive subcortical ischemic disease and also several previous microbleeds. [ncbi.nlm.nih.gov]

Aneurysmal subarachnoid hemorrhage: Epidemiology, risk factors, and pathogenesis. https://www.uptodate.com/contents/search. Accessed May 6, 2022. Dubosh NM, et al. Diagnosis and initial emergency department management of subarachnoid hemorrhage. [mayoclinic.org]

Epidemiology Frequency United States An estimated 10% of intracerebral hemorrhages are believed to be cerebellar in location. An estimated 1-2% of strokes are CHs. [emedicine.medscape.com]

Neurology, Hospital Civil de Guadalajara "Fray Antonio Alcalde", Guadalajara, Jalisco, México. b Department of Neurology and Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Ciudad de México, México. c Department of Epidemiology [j-stroke.org]

View Article PubMed Google Scholar Thrift AG, Donnan GA, McNeil JJ: Epidemiology of intracerebral hemorrhage. Epidemiol Rev. 1995, 17 (2): 361-381. PubMed Google Scholar Auer RN, Sutherland GR: Primary intracerebral hemorrhage: pathophysiology. [jmedicalcasereports.com]

Severe congestion of upper cerebellar veins seemed to be a possible pathophysiology of this specific bleeding pattern. [ncbi.nlm.nih.gov]

We report a patient, having used aspirin for secondary stroke prevention, who had an acute cerebellar hemorrhage after taking nattokinase 400 mg daily for 7 consecutive days. [ncbi.nlm.nih.gov]