Remote cerebellar hemorrhage (zebra sign) in vascular neurosurgery: pathophysiological insights.

Abstract:

:Hemorrhage in regions remote from the site of initial intracranial operations is rare, but may be fatal. Postoperative cerebellar hemorrhage as a complication of supratentorial surgery, with a radiological appearance known as zebra sign, is an increasingly recognized clinical entity and is associated mainly with vascular neurosurgery or temporal lobe resection. The pathophysiology remains unclear. Three cases of remote cerebellar hematoma occurred after neck clipping of anterior communicating artery aneurysms. All patients had similar clinical findings and underwent pterional craniotomy with the head in accentuated extension. One patient died and the two were discharged without symptoms. Cerebellar hemorrhage probably has a multifactorial origin involving positioning associated with abundant cerebrospinal fluid drainage causing cerebellar sag with resultant vein stretching and bleeding, and use of aspirin or other antiplatelet agents.

authors

Figueiredo EG,de Amorim RL,Teixeira MJ

doi

10.2176/nmc.49.229

subject

Has Abstract

pub_date

2009-06-01 00:00:00

pages

229-33; discussion 233-4

issue

6

eissn

0470-8105

issn

1349-8029

pii

JST.JSTAGE/nmc/49.229

journal_volume

49

pub_type

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