Abstract Details

Title Supratentorial Intraparenchymal Hemorrhage Following Spinal Procedures

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P06 - (-)

Poster/Presentation
Number 272

Objective

Background BACKGROUND: IPH secondary to cerebrospinal fluid (CSF) hypotension resulting from spinal procedures is a rare condition with a poorly understood pathophysiology.

Design/Methods DESIGN/METHODS: Case series.

Results RESULTS: The first two cases followed spinal surgery complicated by CSF leaks. Case 1, a 63 year-old woman who experienced sudden onset of aphasia and right facial paresis on post-operative day 19. CT scan showed IPH in the left caudate nucleus with intraventricular extension and a separate focus in the left frontal lobe. Case 2, a 73 year-old male, had focal motor seizures on postoperative day 1. Neuroimaging revealed IPH in the right cerebellum and left parietal lobe, with overlying subarachnoid hemorrhage (SAH). Additionally, both Cases 1 and 2 had bifrontal subdural hematomas. Case 3 involves a 35 year-old woman who underwent lumbar puncture for idiopathic intracranial hypertension. Opening pressure was 50 cm of H20 and dropped to 18 cm of H20 following removal of 10 ml of CSF. Subsequently she developed headache, vomiting, global aphasia, decreased level of consciousness and right-sided hemiparesis. CT scan showed a large left temporo-occipital IPH with overlying SAH and intraventricular extension. None of these cases had conventional risk factors for IPH.

Conclusions CONCLUSIONS: While rare, supratentorial IPH is a serious complication of CSF hypotension. These cases share common features: 1) precipitation of IPH by loss of CSF at the spinal level, and 2) predominantly lobar location of hemorrhages. Awareness of the risk of IPH after spinal procedures is important for early detection and management.

Authors/Disclosures
Christine A. Stables, MD PRESENTER	No disclosure on file
Ashkan Shoamanesh, MD	Dr. Shoamanesh has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bayer AG. Dr. Shoamanesh has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Daiichi Sankyo . Dr. Shoamanesh has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Servier Inc.. Dr. Shoamanesh has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Neurodiem.ca. The institution of Dr. Shoamanesh has received research support from Servier Canada Inc.. The institution of Dr. Shoamanesh has received research support from Daiichi Sankyo Ltd.. The institution of Dr. Shoamanesh has received research support from Bayer AG. The institution of Dr. Shoamanesh has received research support from Bristol-Myers Squibb. The institution of Dr. Shoamanesh has received research support from Octapharma Canada .
Adam Brickman, PhD	Adam Brickman, PhD has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for IQVIA. Adam Brickman, PhD has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Cognito Therapeutics. Adam Brickman, PhD has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for University of Illinois. Adam Brickman, PhD has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for NovoNordisk. Adam Brickman, PhD has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Alzheimer's & Dementia. Adam Brickman, PhD has stock in Tau Biosciences. Adam Brickman, PhD has stock in CogniScreen.
Laura Wilson, MD (Dr Laura K Wilson Inc)	No disclosure on file
	No disclosure on file
Jeff H. Beckman, MD (Dr Jeff H Beckman Inc.)	No disclosure on file
Joseph D. Burns, MD (Lahey Hospital and Medical Center)	Dr. Burns has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elsevier.
Carlos S. Kase, MD, FAHA, FAAN	Dr. Kase has nothing to disclose.
Oscar R. Benavente, MD, FRCP(C) (Gordon and Leslie Diamond Health Care Centre)	No disclosure on file

��ɫ��

��ɫ��