Intracranial Hemorrhage following Spinal Surgery: A Systematic Review of a Rare Complication

Tariq Al-Saadi; Yahya Al-Kindi; Moosa Allawati; Hatem Al-Saadi

doi:10.1055/s-0042-1743525

Intracranial Hemorrhage following Spinal Surgery: A Systematic Review of a Rare Complication

Surg J (N Y). 2022 Mar 3;8(1):e98-e107. doi: 10.1055/s-0042-1743525. eCollection 2022 Jan.

Authors

Tariq Al-Saadi^{1

2}, Yahya Al-Kindi³, Moosa Allawati³, Hatem Al-Saadi⁴

Affiliations

¹ Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital- McGill University, Montreal, Canada.
² Neurosurgery Department, Khoula Hospital, Muscat, Sultanate of Oman.
³ Sultan Qaboos University, College of Medicine and Health Sciences, Muscat, Sultanate of Oman.
⁴ Department of General Surgery, Sohar Hospital, Sohar, Sultanate of Oman.

Abstract

Introduction Intracranial hemorrhage (ICH) is a potentially severe complication of spinal surgeries. The occurrence of such complications causes deterioration of the patient's clinical status and delayed discharge from the hospital. Although no specific etiological factors were identified for this complication, but multiple risk factors might play role in its development, they include the use of anticoagulants, presence of uncontrolled hypertension, and perioperative patient positioning. Aim A systematic review of the literature to investigate the prevalence of different types of intracranial hemorrhages in patients who underwent spinal surgeries. Methods A literature review was conducted using multiple research databases. Data were extracted using multiple variables that were formulated incongruent with the study aim and then further analyzed. Results A total of 79 studies were included in our analysis after applying the exclusion criteria and removing of repeated studies, 109 patients were identified where they were diagnosed with intracranial hemorrhage after spine surgery with a mean age of 54 years. The most common type of hemorrhage was cerebellar hemorrhage (56.0%) followed by SDH and intraparenchymal hemorrhage; 23.9 and 17.4%, respectively. The most common spine surgery was laminectomy (70.6%), followed by fixation and fusion (50.5%), excision of spinal lesions was done in 20.2% of the patient, and discectomy (14.7%). Conclusion The data in this study showed that out of 112 patients with ICH, cerebellar hemorrhage was the most common type. ICH post-spine surgery is a rare complication and the real etiologies behind this complication are still unknown, cerebrospinal fluid drain and durotomy were suggested.

Keywords: hematoma; hemorrhage; intracranial hemorrhage; spinal surgery.

The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. ( https://creativecommons.org/licenses/by/4.0/ ).

Publication types

Review