Cerebellar herniation and infarction as a complication of an occult postoperative lumbar dural defect.

A patient who underwent lumbar spine surgery sustained an occult dural injury. After unrecognized suction drainage of cerebrospinal fluid through a surgical drain, caudal herniation of the cerebellum with superior cerebellar infarction developed. This mechanism should be considered in patients in whom acute mental status changes develop after spinal surgery.