What is the risk of venous cerebellar infarction in the supracerebellar infratentorial approach?

Neurosurg Rev. 2021 Apr;44(2):897-900. doi: 10.1007/s10143-020-01269-4. Epub 2020 Mar 7.

Abstract

The supracerebellar infratentorial approach (SCITA) is a standard approach used in a neurosurgical practice. It carries some risk of associated complications including cerebellar venous infarction with possible serious sequelae. The objective of this study is to address the incidence of cerebellar venous infarction in SCITA. A search through the currently available literature was performed in September 2019 from the year 2000 until September 2019 dealing with 'supracerebellar infratentorial approach'. Out of the 578 patients found in thirteen case series, two venous infarctions were present; the remaining four patients were published as case reports. By analysing the case series, we calculated the risk of such a complication to be 0.345% (95% CI [0.061%, 1.248%]). Case reports were not included. The real risk is estimated to be higher. The risk of cerebellar venous infarction is an unpredictable, infrequent but real complication with potentially dreadful sequelae. Each neurosurgeon using this approach should be aware of this event when employing this approach. The avoidance of cerebellar venous infarction can be lowered by leaving as many bridging veins intact as possible.

Keywords: Bridging vein; Complication; Supracerebellar infratentorial approach; Venous infarction.

Publication types

  • Review

MeSH terms

  • Brain Stem Infarctions / diagnostic imaging
  • Brain Stem Infarctions / surgery*
  • Cerebellum / blood supply
  • Cerebellum / diagnostic imaging
  • Cerebellum / surgery*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neurosurgical Procedures / adverse effects*
  • Neurosurgical Procedures / methods*
  • Neurosurgical Procedures / trends
  • Risk Factors