Postoperative remote cerebellar hemorrhage following lumbar laminectomy without cerebrospinal fluid leak: A rare presentation and review of the literature

Abstract

Here we present a case report detailing an unusual occurrence of Remote Cerebellar Hemorrhage (RCH) post-lumbar laminectomy without the conventional cerebrospinal fluid (CSF) leak. Our patient, a 66-year-old male with neuropathic pain and numbness, underwent a lumbar two to five- laminectomy. Two weeks after the surgery, he developed an intense headache and paresthesia, with neuroimaging revealing superior right cerebellar lesions. Despite comprehensive diagnostic investigations, we found no evidence of typical RCH etiologies such as hypertension, trauma, vascular malformations, or venous sinus thrombosis. This intriguing case not only underscores the need for a multifaceted approach to understanding RCH etiology but also highlights the gaps in our current understanding. Additionally, it contributes to the sparse literature on instances of RCH following lumbar laminectomy in the absence of a CSF leak, thereby emphasizing the importance of continued research into such uncommon occurrences.

Keywords

• Remote cerebellar hemorrhage
• Lumbar laminectomy
• Cerebrospinal fluid leak
• Uncommon presentation
• Etiology review