Postoperative cerebellar hemorrhage after frontal lobe surgery

A 41-year old male was presented to the Emergency Department as a case of generalized tonic clonic seizure. The Glasgow Coma Score (GCS) was 15/15 with minimal right side weakness (4.5/5). Imaging of the brain showed a large (5.0 £ 4.5 £ 4 cm) intra-axial left frontal tumor with extension in the frontal horn of the ventricle and with mild degree of surrounding edema. No anomalies were identified in the posterior fossa (Figure 1). Preoperatively, full history and examination were of a rather healthy male of no comorbidities and all of the investigations including the coagulation profile were within normal values. For the surgery, the patient was in supine position, head turned 30 degrees to the right without jugular compression. A standard left frontal basal craniotomy was developed and the tumor completely excised under neuro-navigation and using microsurgical technique and the ultrasonic aspirator for tumor removal. The frontal horn of the ventricle was opened to remove the intraventricular extension of the tumor and cerebrospinal fluid (CSF) leakage occurred which was expected in the circumstances. The postoperative histopathological finding was of grade III oligodendroglioma. OPEN ACCESS