Spinal subdural hematoma following posterior fossa surgery

SummarySpinal subdural hematoma (SSDH) is a rare but potentially devastating complication of cranial surgery. This study presents two cases of SSDH after posterior fossa surgery. The first case was a 44-year-old man who harbored a fourth ventricle metastatic adenocarcinoma, and the second case was a 4-year-old boy with a posterior fossa medulloblastoma. Both patients underwent suboccipital craniotomy, and SSDHs were found postoperatively. The first case underwent an additional lumbar laminectomy due to cauda equina syndrome; the second case received conservative treatment because there were no obvious neurologic deficits. Meticulous hemostasis and the avoidance of cerebrospinal fluid overdrainage may reduce the risk of SSDH after cranial surgery. Emergent decompression is warranted for SSDH in the presence of progressive neurologic deterioration.