Case Report Remote Hemorrhage in the Cerebellum and Temporal Lobe after Lumbar Spine Surgery Shotaro Watanabe, Seiji Ohtori, Sumihisa Orita, Kazuyo Yamauchi, Yawara Eguchi, Yasuchika Aoki, Junichi Nakamura, Masayuki Miyagi, Miyako Suzuki, Gou Kubota, Kazuhide Inage, Takeshi Sainoh, Jun Sato, Yasuhiro Shiga, Koki Abe, Kazuki Fujimoto, Hiroto Kanamoto, Gen Inoue, Takeo Furuya, Masao Koda, Akihiko Okawa, Kazuhisa Takahashi, and Masashi Yamazaki Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan Correspondence should be addressed to Seiji Ohtori; sohtori@faculty.chiba-u.jp Received 21 April 2015; Accepted 28 June 2015 Academic Editor: Paul Park Copyright © 2015 Shotaro Watanabe et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Cerebellar hemorrhage remote from the site of surgery can complicate neurosurgical procedures. However, this complication afer lumbar surgery is rare. Furthermore, hemorrhage in both the cerebellum and the temporal lobe afer spine surgery is rarer still. Herein we present a case of remote hemorrhage in both the cerebellum and the temporal lobe afer lumbar spine surgery. A 79- year-old woman with a Schwannoma at the L4 level presented with low back and bilateral leg pain refractory to conservative management. Surgery was undertaken to remove the Schwannoma and to perform posterior fusion. During the surgery, the dura mater was removed in order to excise the Schwannoma. Reconstruction of the dura mater was performed; postoperatively the patient had a cerebrospinal fuid leak. Five days afer surgery, clouding of consciousness started gradually, and hemorrhage in the cerebellum and the temporal lobe was revealed by computed tomography. Emergent evacuation of the hemorrhage was performed and the patient recovered consciousness afer the surgery. Leakage of cerebrospinal fuid may have induced this hemorrhage. While rare, intracranial hemorrhage afer spine surgery can occur, sometimes requiring emergent intervention. 1. Introduction Brain hemorrhage is a well known complication afer surgery, but remote cerebellar hemorrhage (RCH) is rare, particularly as a complication afer spinal surgery. Te phenomenon was frst described by Chadduck afer a cervical laminectomy [1]. RCH afer spinal surgery has a reported incidence of 0.08%, and intraoperative cerebrospinal fuid (CSF) loss following dural tear may precipitate it [2–5]. Other areas of the brain may similarly be afected afer spine surgery, as is reported in the literature. Herein we present a case of remote hemorrhage in both the cerebellum and the temporal lobe afer lumbar spine surgery. We review our case as well as the 16 RCH cases afer lumbar spine surgery reported in the litera- ture. 2. Case Presentation Informed consent was received from the patient for this report. In June 2010, a 79-year-old woman presented with a 10-year history of low back pain and bilateral leg pain. Visual analogue scale (VAS) of low back pain was 5 (worst 10), right leg pain was 7, and lef leg pain was 8. Motor weakness using Manual Muscle Testing (MMT) was not observed, and sensory examination using the pin prick test confrmed an abnormality of bilateral L5 dermatomes. Deep tendon refexes were normal in both legs. Tere were no urinary symptoms. Bilateral straight leg raising tests results were negative. Computed tomography (CT) afer myelography showed scalloping of the L4 vertebra (Figure 1). Magnetic resonance imaging (MRI) showed a low signal intensity Hindawi Publishing Corporation Case Reports in Orthopedics Volume 2015, Article ID 972798, 5 pages http://dx.doi.org/10.1155/2015/972798