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Updated: Jun 21, 2026
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Intraoperative Ultrasound in Spinal Surgery
Published on: August 17, 2022
Cervical spinal cord infarction after posterior fossa surgery: a case-based update
Juan F Martínez-Lage1, María-José Almagro, Virginia Izura
1Unit of Pediatric Neurosurgery, Regional Service of Neurosurgery, Virgen de la Arrixaca University Hospital, 30120 El Palmar, Murcia, Spain. juanf.martinezlage@cablemurcia.com
Summary
Posterior fossa surgery can lead to cervical cord infarction and quadriplegia. Careful patient positioning and intraoperative monitoring may help prevent this rare but devastating complication.
Area of Science:
- Neurosurgery
- Neurology
- Vascular Neurology
Background:
- Posterior fossa surgery carries risks, including cervical cord infarction leading to quadriplegia.
- Current patient positioning strategies for posterior fossa lesions lack demonstrated superiority.
Observation:
- A case report details an 8-year-old girl who developed quadriplegia post-surgery for a fourth ventricular ependymoma.
- Postoperative imaging confirmed cervical cord infarction; evoked potentials validated the diagnosis.
Findings:
- Cervical cord infarction may result from compromised blood supply due to tumor infiltration, neck hyperflexion, traction, stenosis, or hypotension.
- Hypothesized cause in the case: tumor infiltration of cervical leptomeninges combined with hypotension during venous air embolism.
Implications:
- Highlights the potential for cervical cord infarction during posterior fossa procedures.
- Suggests the prone position and intraoperative monitoring of evoked potentials as potential preventive strategies.
