Can you figure out the cause of hemorrhage in this case?
Imaging and case details in thread #Neurosurgery #radres #MedTwitter #Neurology @TheASNR #MedEd #neurotwitter
Imaging and case details in thread #Neurosurgery #radres #MedTwitter #Neurology @TheASNR #MedEd #neurotwitter
Initial MRI shows an expansile enhancing mass in the right parasagittal frontal lobe
The patient underwent craniotomy for tumor debulking. Post operative MRI and CT demonstrate hemorrhage in the right cerebellar hemisphere, far from the operative site. What’s the cause of the hemorrhage? 🤔 🧠
Answer: Remote cerebellar hemorrhage
Possible etiology: supratentorial craniotomy leads to reduce CSF volume-> sagging of cerebellum -> vascular tearing or occlusion results in hemorrhage
🧠 RCH is a rare complication of supratentorial craniotomy seen on routine post op imaging
Possible etiology: supratentorial craniotomy leads to reduce CSF volume-> sagging of cerebellum -> vascular tearing or occlusion results in hemorrhage
🧠 RCH is a rare complication of supratentorial craniotomy seen on routine post op imaging
Remote cerebellar hemorrhage:
▶️in the typical post operative setting, RCH does NOT need further evaluation
▶️RCH is self limiting, do not mistake for more ominous diagnoses
ajnr.org/content/27/2/3…
▶️in the typical post operative setting, RCH does NOT need further evaluation
▶️RCH is self limiting, do not mistake for more ominous diagnoses
ajnr.org/content/27/2/3…
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