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Bernal-García, L.M., Cabezudo-Artero, J.M., Ortega-Martínez, M., Fernández-Portales, I., Ugarriza-Echebarrieta, L.F., Pineda-Palomo, M., Porras-Estrada, L.F. and Gómez-Perals, L.F. (2008) Remote Cerebellar Hemorrhage after Lumbar Spinal Fluid Drainage. Report of Two Cases and Literature Review. Neurocirugia (Astur), 19, 440-445.

has been cited by the following article:

• TITLE: Remote Cerebellar Hemorrhage after Frontal Lobectomy: Zebra Sign

  AUTHORS: Can Yaldiz, Volkan Murat Unal, Omer Akar, Onur Yaman, Nail Ozdemir

  KEYWORDS: Zebra Sign, Remote Cerebellar Hemorrhage, Lobectomy

  JOURNAL NAME: Open Journal of Modern Neurosurgery, Vol.4 No.4, October 7, 2014

  ABSTRACT: Remote cerebellar hemorrhages (RCHs) are rare complications of intracranial or spinal interventions. We describe a patient with an RCH that occurred after a frontal lobectomy for an intracranial tumor. A 41-year-old female patient with a headache and partial seizures underwent a right frontal lobectomy upon detection of a right frontal mass. An RCH (zebra sign) was detected on a control cranial computed tomography (CT), which was performed upon detection of frontal lobe syndrome and mild ataxia in the patient postoperatively. Although the mechanism underlying the occurrence of RCHs after intracranial procedures is not clear, they have been attributed to an imbalance between intravascular pressure and cerebrospinal fluid (CSF) due to rapid drainage of the fluid, causing bleeding in the cerebellar parenchyma. Generally, bilateral superior cerebellar injury produces parallel flat hyperdense areas known as the zebra sign on CT. The prognosis of a cerebellar hemorrhage is generally good, and it can be treated with a conservative approach. Controlled drainage of CSF during surgery and selecting an appropriate surgical position perioperatively will reduce the risk of RCHs.