Kartik Manoj Multani¹*, Rahul Srinivasan², Haroon Pillay³, Boyina Jagadeshwar Rajesh⁴ and Kotakadira Srinivas⁵

¹Resident, Department of Neurosurgery, Yashoda Hospital, Secunderabad, India
²Resident, Department of Neurosurgery, Medical Trust Hospital, Kochi, India
³Senior Consultant, Department of Neurosurgery, Medical Trust Hospital, Kochi, India
⁴Senior Consultant, Department of Neurosurgery, Yashoda Hospitals, Secunderabad, India
⁵Associate Professor, Department of Neurosurgery, Gandhi Medical College, Secunderabad, India

*Corresponding Author: Kartik Manoj Multani, Resident, Department of Neurosurgery, Yashoda Hospital, Secunderabad, India.

Received: January 15, 2021; Published: August 19, 2021

Abstract

Postoperative haemorrhages (POH) after any neurosurgical procedure can be seen at surgical site or at virgin sites away from operative field, more commonly known as remote haemorrhages. Cerebellum is the most common site of remote POH while supratentorial remote POH are very sparsely described in literature. usually benign in their clinical course but sometime can condemn patients to devastating morbidity and mortality. Due to the rare reporting, natural history of remote POH and its exact pathophysiology is not very well known that can put clinicians in a jumbled position. Multiple theories have tried to explain its genesis, of which most widely accepted are “Cerebellar sag theory” and “Drain theory”. Other theories that lack good supportive evidence blames surgical position, sudden decompression of intraaxial lesion, preoperative coagulation defects and cryptic vascular malformations as plausible culprits for remote POH. Their treatment is usually based on severity of clinical presentation and can range from observation to need of surgical evacuations.

In this report we present our experience with identification of two cases with remote POH, case 1 is a first in world literature report describing a combined remote supratentorial and cerebellar POH and case 2 describes a classical remote cerebellar haemorrhage. Both had benign clinical course and were managed conservatively. We also reviewed the literature and discussed the theories behind its pathophysiology in general and pertaining to our experience.

Keywords: Cerebellar Sag Theory; Postoperative Haemorrhages (POH); Drain Theory

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Citation

Citation: Kartik Manoj Multani., et al. “Postoperative Intracranial Remote Haemorrhages: An Experience from 2 Tertiary Care Hospitals". Acta Scientific Neurology 4.9 (2021): 41-45.

Copyright

Copyright: © 2021 Kartik Manoj Multani., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.