Remote site hemorrhage mechanism, management and outcome? Case report and literature review

Abstract

Background: Remote site hemorrhage (RSH) is a rare neurosurgical condition that occurs supra or infratentorial, away from the operation site after sudden decompression of high intracranial pressure (ICP) patients. Many surgeons have experienced such cases. Reviewing the literature shows that this kind of hemorrhage were mostly occurred in the cerebellum, has been named remote cerebellar hemorrhage (RCH). Case description: Herein, we present a patient with remnant olfactory groove meningioma, in whom RSH was happened in the left temporal lobe just post-operation and subsequently RCH was occurred 48 h later. Finally, the patient was discharged without any neurologic deficit, after several days of conservative management. Conclusion: Although no confirmed mechanism has been reported for RSH yet, excessive sudden cerebrospinal fluid drainage, whether intra-operative or post-operative, and consequently intracranial hypotension can be assumed as a major risk factor for it.

Keywords

• Remote site hemorrhage
• Remote cerebellar hemorrhage
• Intracranial pressure