• Daniel G Lewis, Simon Lloyd, Omar N Pathmanaban, Charlotte Hammerbeck-Ward, Scott A Rutherford, and Andrew T King.
• Department of Neurosurgery, Salford Royal Hospital, Salford, Greater Manchester, United Kingdom. Electronic address: Daniel.lewis@srft.nhs.uk.
• World Neurosurg. 2016 May 1; 89: 726.e15-7.

BackgroundA man developed a rare and unexpected contralateral intraoperative complication during a translabyrinthine resection of a large cystic vestibular schwannoma.Case DescriptionA 29-year-old man presented with progressive, low-level right-sided tinnitus and hearing loss. Magnetic resonance imaging displayed a large multicystic lesion suggestive of a vestibular schwannoma extending into the right cerebellopontine angle and distorting the midbrain. The patient subsequently underwent translabyrinthine excision of the lesion. The operation was complicated by brain swelling that obscured the operative field. Cerebrospinal fluid drainage failed to improve operative conditions, and an urgent computed tomography scan was performed, which showed a large supratentorial extradural hematoma as the cause. This extradural collection was promptly evacuated, and the patient had a good neurologic recovery postoperatively.ConclusionsAlthough the development of postoperative extradural hematomas resulting from cerebrospinal fluid overdrainage is reported in the literature, this case is unique in that infratentorial surgery led to the development of a supratentorial hematoma.Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

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