Related Experiment Video
Updated: Aug 10, 2026
09:01
Minimally Invasive Endoscopic Intracerebral Hemorrhage Evacuation
Published on: October 15, 2021
Intracerebral hemorrhage occurring remote from the craniotomy site
M H Brisman1, J B Bederson, C N Sen
1Department of Neurosurgery, Mount Sinai Medical Center, New York, New York, USA.
Neurosurgery
|December 1, 1996
Summary
Remote intracerebral hemorrhage is a rare but serious complication following craniotomy. These hemorrhages, occurring away from the surgical site, are associated with significant disability and death.
Area of Science:
- Neurosurgery
- Neurology
- Clinical Medicine
Background:
- Postoperative intracerebral hemorrhage (ICH) remote from the craniotomy site is a rare but significant complication.
- Understanding the characteristics and risk factors of remote ICH is crucial for improving patient outcomes.
Observation:
- Reviewed 37 cases of remote postoperative ICH (5 from own records, 32 from literature).
- Remote ICH occurred within hours postoperatively in 78% of cases.
- Specific craniotomy locations and patient positioning (sitting) were associated with particular patterns of remote ICH.
Findings:
- Remote ICH was not linked to lesion type, hypertension, coagulopathy, CSF drainage, or occult lesions.
- Supratentorial procedures often led to infratentorial hemorrhages (sylvian fissure, paraclinoid region), and infratentorial procedures (sitting position) led to supratentorial hemorrhages.
- Remote hemorrhages were superficial and lobar, differing from typical hypertensive locations.
Implications:
- Remote ICH is a rare complication with high morbidity (14% severe disability) and mortality (32% death).
- Hemorrhage development is likely early, linked to surgical factors, positioning, and mechanical influences.
- These findings highlight the need for vigilance and further research into the pathogenesis and prevention of remote ICH.
More Related Videos
Related Concept Videos
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...
01:29Hemorrhagic 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...
01:29Increased 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...