LAUSR

et al. reported a 2% (7 out of 338 cases) incidence of hematoma following suboccipital retrosigmoid approach for these tumors.[1] They are associated with significant mortality and morbidity. They may be more common with cystic vestibular schwannoma as in our case.[2] The reported sites of hematomas include operative site, cerebellar parenchyma, brainstem hematomas, operative‐site extradural hematomas, and remote supratentorial hematomas such as supratentorial extra‐ and sub‐dural hematomas.[1,3,4] The causes may be due to inadequate hemostasis, retraction injury, venous infarction, excess drain of cerebrospinal fluid, or vascular injury during surgery. In our case, blood was predominantly in the ventricular system and this location of hematoma has not yet been described in literature. On retrospective analysis of the surgical video, it was found that there was a small arterial vessel which was bleeding from the choroid plexus at the foramen of Luschka, it was controlled with cottonoid pressure. This vessel could have retracted and continued to bleed, causing the blood to track through the Luschka enter the 4th ventricle and ascend to involve the supratentorial ventricles.