Perioperative intracranial hemorrhage in achondroplasia - A case report

We report a case of a 35-year-old man with achondroplasia who previously ha d thoracolumbar decompressive laminectomies, who developed recurrence of sp inal stenosis at the thoracolumbar junction. The patient underwent standard repeat thoracolumbar decompression, removal of a disc, and spinal fusion w ith instrumentation in the prone position. Postoperatively the patient was confused. Computed tomography (CT) revealed hemorrhages in both cerebellar hemispheres with surrounding edema and mild mass effect. These were interpr eted as venous hemorrhages. Conservative therapy was successful. This is th e first case report of perioperative venous intracranial hemorrhage in the context of spinal surgery for achondroplasia. Distinctive anatomic characte ristics of achondroplasia, combined with several potentially modifiable asp ects of his management, may have predisposed the patient to this complicati on.