Supratentorial Surgery Complicated by Cerebellar Hemorrhage: Report of Three Cases

ABSTRACT

Among the complications of intracranial surgery, postoperative hemorrhage remote from the operative site is rare, especially when it occurs in the cerebellum after surgery involving the supratentorial region. We report three cases of cerebellar hemorrhage after supratentorial surgery 1) A 66-year-old man with subdural hygroma in both frontotemporal areas ; 2) A 56-year-old man with chronic subdural hematoma in the left frontotemporal area ; 3) A 39-year-old woman with aneurysms at the right middle cerebral artery bifurcation and basilar tip. The possible etiologies of cerebellar hemorrhage in the three cases presented here were reviewed. We speculate that when the patient is in the supine position with head rotated and extended, the displacement of the cerebellum causes stretching of the superior vermian veins and their tributaries, resulting in tearing of these vessels, and that a sudden decrease in intracranial pressure may accelerate this process. To prevent this complication, meticulous perioperative management of the patient is essential.