Introduction:

Hemorrhage around the operative site is common following neurosurgical procedures. And also hemorrhage at remote sites such as epidural, subdural or subarachnoid spaces is also not uncommon. But cerebellar hemorrhage after supratentorial neurosurgical operations is a rare, self-limiting phenomenon.and lots of cases have been reported in the neurosurgical literature. But, to the best of our knowledge, remote cerebellary hemorrhage after spinal arteriovenous fistula (DAVF) repairing operation has not been described with imaging findings in the literature previously.

Case Report:

A 46-year-old woman with dorsolumbary non-radicular pain whom had a type I spinal DAVF underwent neurosurgical operation under general anestesia is presented. She was discharged from the intensive care unit with no early postoperative complication. A few days later, she had a severe headache, visual disturbance and confusion. A control cranial MRI examination had to be done with the prediagnosis of intracranial hypotension. At the MRI, there were bilaterally cerebellary hemispheric fusiform hemorrhages which confirmed on conventional sequences. Neither an underlying lesions were identified nor any enhancement was seen on the postcontrast T1-weighted MR images. Control CT myelography confirmed lumbary CSF fistula formation. At 3-month follow-up, CSF fistula formation had been resolved spontaneously and the patient had no symptoms or neurologic deficits.

Conclusion:

RCH (remote cerebellar hemorrhage) is an alarming but seldom reported complication of supratentorial craniotomies. With this unique case which present RCH after spinal DAVF operation, support the hypothesis of cerebellar sagging due to CSF hypovolemia. But RCH is also a self-limiting phenomenon, and further surgical or diagnostic invasive evaluation directed to the secondary affected area (cerebellum for our case) is not required.

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