Related Experiment Video
Updated: May 18, 2026
09:14
Pre-Chiasmatic, Single Injection of Autologous Blood to Induce Experimental Subarachnoid Hemorrhage in a Rat Model
Published on: June 18, 2021
Multiple intracranial hemorrhages after cervical spinal surgery
Yuichi Takahashi1, Kenki Nishida, Koichi Ogawa
1Department of Spine and Spinal Surgery, Shinkomonji Hospital, Fukuoka, Japan. yuichi5356@yahoo.co.jp
Neurologia Medico-Chirurgica
|September 26, 2012
Summary
A rare case of multiple intracranial hemorrhages occurred after cervical laminoplasty. Careful monitoring of wound drainage is crucial to prevent complications like low intracranial pressure.
Area of Science:
- Neurosurgery
- Neurology
Background:
- Cervical laminoplasty is a surgical procedure to treat cervical spondylotic myelopathy.
- Intracranial hemorrhages are a potential, though rare, complication following spinal surgery.
Observation:
- A 69-year-old woman developed multiple supra- and infratentorial intracranial hemorrhages post-cervical laminoplasty.
- The patient had a wound drainage tube with significant fluid output (380 ml in 12 hours) but no intraoperative cerebrospinal fluid leak.
- Postoperative CT revealed cerebellar hemorrhage, subdural hemorrhage, subarachnoid hemorrhage, intraparenchymal hemorrhage, and pneumocephalus.
Findings:
- The patient was treated medically and recovered without significant neurological deficits, except for right hemianopsia.
- Overdrainage of cerebrospinal fluid through an undetected dural tear is suspected as the cause of low intracranial pressure, leading to hemorrhages.
Implications:
- This case highlights the risk of intracranial hemorrhages secondary to cerebrospinal fluid overdrainage, even without obvious intraoperative leakage.
- Thorough control and monitoring of wound drainage are essential in patients undergoing cervical spine surgery to prevent potentially severe intracranial complications.
Related Concept Videos
01:29Hemorrhagic Stroke ll: Pathophysiology
A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
01:17Hemorrhagic Stroke l: Introduction
A hemorrhagic stroke is an acute neurological event that occurs when a weakened cerebral blood vessel ruptures, allowing blood to accumulate within or around the brain. The sudden release of blood forms a focal hematoma that increases intracranial pressure, displaces neural tissue, and can obstruct cerebrospinal fluid pathways. These effects may be compounded by intraventricular extension of the hemorrhage, cerebral edema, or compression of adjacent structures, all of which contribute to...
01:14Increased Intracranial Pressure l: Introduction
Intracranial hypertension is a sustained elevation of intracranial pressure (ICP) above 22 mm Hg. In supine adults, normal ICP is ~7–15 mm Hg.The rigid, nonexpandable cranium contains three components—brain tissue, blood, and cerebrospinal fluid (CSF)—that total ~1,700 mL in a typical adult: 1,400 mL brain (~80%), 150 mL blood (~10%), and 150 mL CSF (~10%). According to the Monro–Kellie doctrine, total intracranial volume is effectively fixed. When one component expands, CSF and venous blood...
01:29Increased Intracranial Pressure ll: Pathophysiology
Increased intracranial pressure (ICP) refers to a potentially life-threatening rise in pressure inside the skull. This usually happens when there is a major change in the volume of brain tissue, blood, or cerebrospinal fluid (CSF) — the three components inside the skull. According to the Monro-Kellie doctrine, if the volume of one component increases, the volumes of the other components must decrease to maintain normal pressure. If this does not happen, ICP rises.The process often begins with...
01:22Cerebral Edema ll: Pathophysiology
Vasogenic edema is a major form of cerebral edema characterized by abnormal accumulation of fluid in the brain’s extracellular space due to disruption of the blood–brain barrier (BBB). The BBB is a specialized structure composed of endothelial cells connected by tight junctions, supported by astrocytic endfeet and a basement membrane. Under normal conditions, it tightly regulates the movement of ions, proteins, and solutes between the bloodstream and brain parenchyma. When this barrier loses...
01:22Aneurysm IV: Nursing Management
Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...