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  • Title: Multiple supra- and infratentorial intraparenchymal hemorrhages presenting with seizure after massive sacral cerebrospinal fluid drainage.
    Author: Bowers CA, Taussky P, Duhon BS, Schmidt MH.
    Journal: Spine (Phila Pa 1976); 2011 Feb 15; 36(4):E288-91. PubMed ID: 21270696.
    Abstract:
    STUDY DESIGN: Case report and review of the literature. OBJECTIVE: To describe a case of multiple supra- and infratentorial hemorrhages after spinal surgery presenting with seizure. SUMMARY OF BACKGROUND DATA: Cerebrospinal fluid overdrainage is a well-documented factor associated with remote cerebellar hemorrhage, but supratentorial hemorrhages after spinal surgery have been reported rarely. METHODS: A 64-year-old woman underwent a sacral laminectomy for recurrent chordoma. A negative pressure wound drain was left in after surgery and drained 1300 mL in the first 48 hours. On the fourth postoperative day, the patient presented with tonic-clonic seizures. RESULTS: Diagnostic imaging showed multiple supra- and infratentorial intraparenchymal hemorrhages and a massive sacral cerebrospinal fluid leak. The patient underwent emergent surgery for a primary repair of the presumed dural defect. CONCLUSION: Patients who present with severe positional headache, altered mental status, or tonic-clonic seizures after undergoing intradural spinal procedures involving massive cerebrospinal fluid loss may be suffering from multiple supra- and infratentorial intracranial hemorrhages.
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