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KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
TERMINOLOGY
Abbreviations
- Remote cerebellar hemorrhage (RCH)
Definitions
- Cerebellar hemorrhage following CNS surgery, typically supratentorial
- Remote to primary surgical site
- No underlying pathologic lesion
- Cerebrospinal fluid (CSF) drainage → cerebellar "sagging" → vein stretching, bleeding
- Less commonly may occur after spinal surgery
- Smaller subset of patients with supratentorial hemorrhage
- Following infratentorial (remote) surgery
- Cerebellar hemorrhage following CNS surgery, typically supratentorial
IMAGING
General Features
CT Findings
MR Findings
Angiographic Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
- Doddamani RS et al: Remote cerebellar hemorrhage following surgery for supratentorial lesions. World Neurosurg. 126:e351-9, 2019
- Hofler RC et al: Cerebellar hemorrhage following an uncomplicated lumbar spine surgery: case report. J Stroke Cerebrovasc Dis. 28(7):e104-5, 2019
- Sturiale CL et al: Remote cerebellar hemorrhage after spinal procedures (part 2): a systematic review. Neurosurg Rev. 39(3):369-76, 2016
- Sturiale CL et al: Remote cerebellar hemorrhage after supratentorial procedures (part 1): a systematic review. Neurosurg Rev. 39(4):565-73, 2016
- Mallio CA et al: Bilateral remote cerebellar haemorrhage after spinal surgery: a case study and review of the literature. Brain Inj. 28(9):1216-22, 2014
- Smith R et al: Remote cerebellar hemorrhage following supratentorial cerebrovascular surgery. J Clin Neurosci. 21(4):673-6, 2014
- Borkar SA et al: Remote site intracranial haemorrhage: a clinical series of five patients with review of literature. Br J Neurosurg. 27(6):735-8, 2013
- Thangasamy SJ et al: Remote cerebellar hemorrhage as an unusual complication of supratentorial surgery. A case report and literature review. Neuroradiol J. 24(5):779-82, 2011
- Huang CY et al: Remote cerebellar hemorrhage after supratentorial unruptured aneurysm surgery: report of three cases. Neurol Res. 32(6):670-2, 2010
- Figueiredo EG et al: Remote cerebellar hemorrhage (zebra sign) in vascular neurosurgery: pathophysiological insights. Neurol Med Chir (Tokyo). 49(6):229-33; discussion 233-4, 2009
- Amini A et al: Remote cerebellar hemorrhage. AJNR Am J Neuroradiol. 27(2):387-90, 2006
- Kelley GR et al: Sinking brain syndrome: craniotomy can precipitate brainstem herniation in CSF hypovolemia. Neurology. 62(1):157, 2004
- Bloch J et al: Brain stem and cerebellar dysfunction after lumbar spinal fluid drainage: case report. J Neurol Neurosurg Psychiatry. 74(7):992-4, 2003
- Friedman JA et al: Cerebellar hemorrhage after spinal surgery: report of two cases and literature review. Neurosurgery. 50(6):1361-3; discussion 1363-4, 2002
- Honegger J et al: Cerebellar hemorrhage arising postoperatively as a complication of supratentorial surgery: a retrospective study. J Neurosurg. 96(2):248-54, 2002
- Marquardt G et al: Cerebellar hemorrhage after supratentorial craniotomy. Surg Neurol. 57(4):241-51; discussion 251-2, 2002
- Friedman JA et al: Remote cerebellar hemorrhage after supratentorial surgery. Neurosurgery. 49(6):1327-40, 2001
- Seoane E et al: Compression of the internal jugular vein by the transverse process of the atlas as the cause of cerebellar hemorrhage after supratentorial craniotomy. Surg Neurol. 51(5):500-5, 1999
- Cloft HJ et al: Posterior fossa hemorrhage after supratentorial surgery. AJNR Am J Neuroradiol. 18(8):1573-80, 1997
- Brisman MH et al: Intracerebral hemorrhage occurring remote from the craniotomy site. Neurosurgery. 39(6):1114-21; discussion 1121-2, 1996
- Toczek MT et al: Cerebellar hemorrhage complicating temporal lobectomy. Report of four cases. J Neurosurg. 85(4):718-22, 1996
- Waga S et al: Intracerebral hemorrhage remote from the site of the initial neurosurgical procedure. Neurosurgery. 13(6):662-5, 1983
- Haines SJ et al: Supratentorial intracerebral hemorrhage following posterior fossa surgery. J Neurosurg. 49(6):881-6, 1978
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
TERMINOLOGY
Abbreviations
- Remote cerebellar hemorrhage (RCH)
Definitions
- Cerebellar hemorrhage following CNS surgery, typically supratentorial
- Remote to primary surgical site
- No underlying pathologic lesion
- Cerebrospinal fluid (CSF) drainage → cerebellar "sagging" → vein stretching, bleeding
- Less commonly may occur after spinal surgery
- Smaller subset of patients with supratentorial hemorrhage
- Following infratentorial (remote) surgery
- Cerebellar hemorrhage following CNS surgery, typically supratentorial
IMAGING
General Features
CT Findings
MR Findings
Angiographic Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
- Doddamani RS et al: Remote cerebellar hemorrhage following surgery for supratentorial lesions. World Neurosurg. 126:e351-9, 2019
- Hofler RC et al: Cerebellar hemorrhage following an uncomplicated lumbar spine surgery: case report. J Stroke Cerebrovasc Dis. 28(7):e104-5, 2019
- Sturiale CL et al: Remote cerebellar hemorrhage after spinal procedures (part 2): a systematic review. Neurosurg Rev. 39(3):369-76, 2016
- Sturiale CL et al: Remote cerebellar hemorrhage after supratentorial procedures (part 1): a systematic review. Neurosurg Rev. 39(4):565-73, 2016
- Mallio CA et al: Bilateral remote cerebellar haemorrhage after spinal surgery: a case study and review of the literature. Brain Inj. 28(9):1216-22, 2014
- Smith R et al: Remote cerebellar hemorrhage following supratentorial cerebrovascular surgery. J Clin Neurosci. 21(4):673-6, 2014
- Borkar SA et al: Remote site intracranial haemorrhage: a clinical series of five patients with review of literature. Br J Neurosurg. 27(6):735-8, 2013
- Thangasamy SJ et al: Remote cerebellar hemorrhage as an unusual complication of supratentorial surgery. A case report and literature review. Neuroradiol J. 24(5):779-82, 2011
- Huang CY et al: Remote cerebellar hemorrhage after supratentorial unruptured aneurysm surgery: report of three cases. Neurol Res. 32(6):670-2, 2010
- Figueiredo EG et al: Remote cerebellar hemorrhage (zebra sign) in vascular neurosurgery: pathophysiological insights. Neurol Med Chir (Tokyo). 49(6):229-33; discussion 233-4, 2009
- Amini A et al: Remote cerebellar hemorrhage. AJNR Am J Neuroradiol. 27(2):387-90, 2006
- Kelley GR et al: Sinking brain syndrome: craniotomy can precipitate brainstem herniation in CSF hypovolemia. Neurology. 62(1):157, 2004
- Bloch J et al: Brain stem and cerebellar dysfunction after lumbar spinal fluid drainage: case report. J Neurol Neurosurg Psychiatry. 74(7):992-4, 2003
- Friedman JA et al: Cerebellar hemorrhage after spinal surgery: report of two cases and literature review. Neurosurgery. 50(6):1361-3; discussion 1363-4, 2002
- Honegger J et al: Cerebellar hemorrhage arising postoperatively as a complication of supratentorial surgery: a retrospective study. J Neurosurg. 96(2):248-54, 2002
- Marquardt G et al: Cerebellar hemorrhage after supratentorial craniotomy. Surg Neurol. 57(4):241-51; discussion 251-2, 2002
- Friedman JA et al: Remote cerebellar hemorrhage after supratentorial surgery. Neurosurgery. 49(6):1327-40, 2001
- Seoane E et al: Compression of the internal jugular vein by the transverse process of the atlas as the cause of cerebellar hemorrhage after supratentorial craniotomy. Surg Neurol. 51(5):500-5, 1999
- Cloft HJ et al: Posterior fossa hemorrhage after supratentorial surgery. AJNR Am J Neuroradiol. 18(8):1573-80, 1997
- Brisman MH et al: Intracerebral hemorrhage occurring remote from the craniotomy site. Neurosurgery. 39(6):1114-21; discussion 1121-2, 1996
- Toczek MT et al: Cerebellar hemorrhage complicating temporal lobectomy. Report of four cases. J Neurosurg. 85(4):718-22, 1996
- Waga S et al: Intracerebral hemorrhage remote from the site of the initial neurosurgical procedure. Neurosurgery. 13(6):662-5, 1983
- Haines SJ et al: Supratentorial intracerebral hemorrhage following posterior fossa surgery. J Neurosurg. 49(6):881-6, 1978
