• Christian A Bowers, Philipp Taussky, Bradley S Duhon, and Meic H Schmidt.
• Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, USA.
• Spine. 2011 Feb 15;36(4):E288-91.

Study DesignCase report and review of the literature.ObjectiveTo describe a case of multiple supra- and infratentorial hemorrhages after spinal surgery presenting with seizure.Summary Of Background DataCerebrospinal fluid overdrainage is a well-documented factor associated with remote cerebellar hemorrhage, but supratentorial hemorrhages after spinal surgery have been reported rarely.MethodsA 64-year-old woman underwent a sacral laminectomy for recurrent chordoma. A negative pressure wound drain was left in after surgery and drained 1300 mL in the first 48 hours. On the fourth postoperative day, the patient presented with tonic-clonic seizures.ResultsDiagnostic imaging showed multiple supra- and infratentorial intraparenchymal hemorrhages and a massive sacral cerebrospinal fluid leak. The patient underwent emergent surgery for a primary repair of the presumed dural defect.ConclusionPatients who present with severe positional headache, altered mental status, or tonic-clonic seizures after undergoing intradural spinal procedures involving massive cerebrospinal fluid loss may be suffering from multiple supra- and infratentorial intracranial hemorrhages.

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