Remote peritentorial hemorrhage complicating supratentorial aneurysmal surgery: a report of three cases and literature review

Acta Neurochir (Wien). 2013 Feb;155(2):271-6. doi: 10.1007/s00701-012-1540-9. Epub 2012 Oct 30.

Abstract

We herein coin the term "remote peritentorial hemorrhage (RPTH)" and present three cases with "RPTH" after supratentorial aneurysmal surgeries, including two with remote cerebellar hemorrhage (RCH) and one with remote temporobasal hemorrhage. The RCH may result from rupture of the superior cerebellar veins due to excessive cerebrospinal fluid (CSF) loss. The mechanism behind the remote temporobasal hemorrhage may be similar to that of RCH. It can be explained by tearing of the temporobasal veins as a result of brain shift owing to intracranial hypotension stemming from intensive loss of CSF. As far as we know, this is the first report of such a bleeding pattern of probable venous origin. The results of this study could shed light on the "RPTH" physiopathology.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Aneurysm, Ruptured / diagnosis
  • Aneurysm, Ruptured / physiopathology
  • Aneurysm, Ruptured / surgery*
  • Cerebellum*
  • Cerebral Hemorrhage / diagnosis*
  • Cerebral Hemorrhage / etiology*
  • Cerebral Hemorrhage / therapy
  • Craniotomy / adverse effects*
  • Female
  • Humans
  • Intracranial Aneurysm / diagnosis
  • Intracranial Aneurysm / physiopathology
  • Intracranial Aneurysm / surgery*
  • Male
  • Middle Aged