Supratentorial space occupying lesions following infratentorial surgery early diagnosis and treatment.

Supratentorial complications of infratentorial surgery are rare. In the last 3 years we have operated on 187 patients with infratentorial lesions and have observed an incidence of 3.7% of supratentorial haemorrhages. Postoperative intracranial air, as shown by early postoperative CT control, was encountered mainly in a subdural frontal location and within the interhemispheric fissure. We performed no surgical decompression of the air accumulation because of the lack of clinical symptoms. Predisposing factors for the development of supratentorial complications remote from the surgical area are hypertonia, female sex, brain atrophy and preoperative shunting procedures. Measures to avoid these complications are discussed.