{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:51:40Z","timestamp":1786125100669,"version":"build-2736575974"},"reference-count":12,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Operative Surg.","ONSURG"],"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>BACKGROUND AND IMPORTANCE<\/jats:title>\n                    <jats:p>Decompression surgery for Chiari malformation is known to have very low procedure-related complications. There has been no report of post-Chiari malformation decompression surgery development of brainstem hemorrhage. We report 2 post-Chiari decompression surgery brainstem hemorrhage cases with 2-yr follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CLINICAL PRESENTATION<\/jats:title>\n                    <jats:p>Two cases were reviewed in which patients underwent uncomplicated suboccipital craniectomy with expansive autologous pericranium duraplasty for Chiari decompression. Postoperatively, both patients awoke with hemibody sensory and motor deficits. Immediate postoperative magnetic resonance imaging revealed a small hemorrhage within the dorsal medulla in both cases. Follow-up imaging shows resolution along with near complete clinical recovery of deficits.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>These cases demonstrate a rare postdecompression surgery-related complication in Chiari malformation. We hypothesize that these hemorrhages may occur from the rapid drainage of cerebrospinal fluid resulting in a loss of positive pressure, allowing a low-pressure hemorrhage to occur. Given that these hemorrhages are of low pressure, recovery is excellent.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ons\/opx146","type":"journal-article","created":{"date-parts":[[2017,7,11]],"date-time":"2017-07-11T10:13:16Z","timestamp":1499767996000},"page":"E58-E62","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["A Report of 2 Cases of Brainstem Hemorrhage After Suboccipital Craniectomy for Chiari Decompression"],"prefix":"10.1227","volume":"14","author":[{"given":"Sean P","family":"Polster","sequence":"first","affiliation":[{"name":"Section of Neurosurgery, Department of Surgery, University of Chicago Medi-cine, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark C","family":"Dougherty","sequence":"additional","affiliation":[{"name":"Section of Neurosurgery, Department of Surgery, University of Chicago Medi-cine, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hussein A","family":"Zeineddine","sequence":"additional","affiliation":[{"name":"Section of Neurosurgery, Department of Surgery, University of Chicago Medi-cine, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seon-Kyu","family":"Lee","sequence":"additional","affiliation":[{"name":"Section of Neuro-interventional Radiology, Department of Radiology, University of Chicago Medi-cine, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Frim","sequence":"additional","affiliation":[{"name":"Section of Neurosurgery, Department of Surgery, University of Chicago Medi-cine, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2018,5]]},"reference":[{"issue":"5","key":"bib1-20240909","doi-asserted-by":"crossref","first-page":"823","DOI":"10.3171\/jns.1991.75.5.0823","article-title":"Chiari's description of cerebellar ectopy (1891). With a summary of Cleland's and Arnold's contributions and some early observations on neural-tube defects","volume":"75","author":"Koehler","year":"1991","journal-title":"J Neurosurg."},{"issue":"5","key":"bib2-20240909","doi-asserted-by":"crossref","first-page":"1086","DOI":"10.2214\/AJR.15.14314","article-title":"MRI findings after surgery for Chiari malformation type I","volume":"205","author":"Rozenfeld","year":"2015","journal-title":"AJR Am J Roentgenol."},{"issue":"5","key":"bib4-20240909","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1159\/000445899","article-title":"Parent-reported executive dysfunction in children and adolescents with Chiari malformation type 1","volume":"51","author":"Lacy","year":"2016","journal-title":"Pediatr Neurosurg."},{"issue":"1","key":"bib5-20240909","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1159\/000089504","article-title":"The Chiari pseudotumor cerebri syndrome: symptom recurrence after decompressive surgery for Chiari malformation type I","volume":"42","author":"Fagan","year":"2006","journal-title":"Pediatr Neurosurg."},{"issue":"2","key":"bib8-20240909","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1227\/NEU.0b013e31825c3426","article-title":"Surgical treatment of Chiari I malformation\u2013analysis of intraoperative findings, complications, and outcome for 371 foramen magnum decompressions","volume":"71","author":"Klekamp","year":"2012","journal-title":"Neurosurgery."},{"issue":"7","key":"bib9-20240909","doi-asserted-by":"crossref","first-page":"694","DOI":"10.1179\/1743132812Y.0000000066","article-title":"Positive and negative predictors for good outcome after decompressive surgery for Chiari malformation type 1 as scored on the Chicago Chiari Outcome Scale","volume":"34","author":"Hekman","year":"2012","journal-title":"Neurol Res."},{"issue":"2","key":"bib10-20240909","doi-asserted-by":"crossref","first-page":"161","DOI":"10.3171\/2014.10.PEDS14295","article-title":"Pediatric and adult Chiari malformation type I surgical series 1965\u20132013: a review of demographics, operative treatment, and outcomes","volume":"15","author":"Arnautovic","year":"2015","journal-title":"J Neurosurg Pediatr."},{"issue":"2","key":"bib11-20240909","doi-asserted-by":"crossref","first-page":"134","DOI":"10.2176\/nmc.51.134","article-title":"Remote cerebellar hemorrhage after foramen magnum decompression surgery for Chiari I malformation\u2013case report","volume":"51","author":"Kaneko","year":"2011","journal-title":"Neurol Med Chir (Tokyo)."},{"issue":"8","key":"bib12-20240909","doi-asserted-by":"crossref","first-page":"1684","DOI":"10.1161\/01.STR.25.8.1684","article-title":"Primary medullary hemorrhage. Report of four cases and review of the literature","volume":"25","author":"Barinagarrementeria","year":"1994","journal-title":"Stroke."},{"issue":"1","key":"bib13-20240909","first-page":"102","article-title":"Does ventricular opening promote remote cerebellar haemorrhage?","volume":"22","author":"Ziyal","year":"2012","journal-title":"Turk Neurosurg."},{"issue":"6","key":"bib14-20240909","first-page":"1361","article-title":"Cerebellar hemorrhage after spinal surgery: report of two cases and literature review","volume":"50","author":"Friedman","year":"2002","journal-title":"Neurosurgery."},{"issue":"10","key":"bib15-20240909","doi-asserted-by":"crossref","first-page":"834","DOI":"10.1016\/j.ijscr.2013.06.014","article-title":"Remote contralateral intraparenchymal hemorrhage after overdrainage of a chronic subdural hematoma","volume":"4","author":"Cohen-Gadol","year":"2013","journal-title":"Int J Surg Case Rep."}],"container-title":["Operative Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ons\/article-pdf\/14\/5\/E58\/30208677\/opx146.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ovid.com\/01787389-201805000-00023","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:50:17Z","timestamp":1786121417000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/01787389-201805000-00023"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,7,11]]},"references-count":12,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2018]]}},"URL":"https:\/\/doi.org\/10.1093\/ons\/opx146","relation":{},"ISSN":["2332-4252","2332-4260"],"issn-type":[{"value":"2332-4252","type":"print"},{"value":"2332-4260","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,7,11]]},"assertion":[{"value":"2017-01-03","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-05-22","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}