Supratentorial Intracerebral Hematoma as a Rare Complication of Posterior Fossa Surgery in Prone Position: A Case Report with Review of Literature.

Abstract

Supratentorial intracerebral hematoma is a rare complication after posterior fossa tumor surgery in prone positioning. Although rare, its occurrence may cause significant impact on survival of the patient. We had described this rare complication and their possible pathophysiology in this report. A 52-year-old male with fourth ventricle epidermoid tumor with noncommunicative hydrocephalus was presented to us in drowsy condition in emergency department. Right-sided medium pressure ventriculoperitoneal surgery was performed in emergency. After shunt surgery patient become conscious and oriented. Total excision of tumor was done via suboccipital craniotomy in prone positioning after preanesthesia fitness. Patient extubated from anesthesia and was conscious but after 2 hours patient condition deteriorated. Patient was intubated again and taken on ventilatory support. Postoperative plain computed tomography brain showed total excision of tumor with left temporal lobe hematoma. Patient was managed conservatively and his condition improved in 3 weeks' periods. Supratentorial intracerebral hematoma after posterior fossa surgery in prone positioning is a rare complication. Despite the rarity of this complication, it is still challenging as it may lead to significant morbidity and mortality.