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CC BY 4.0 · Arq Neuropsiquiatr 2025; 83(07): s00451809934
DOI: 10.1055/s-0045-1809934
Original Article

Clinical characterization, natural history, and neuroimaging of cerebellar ataxia after abdominal surgery

Victor Rebelo Procaci 
1   Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Neurologia e Neurocirurgia, Unidade de Ataxias, São Paulo SP, Brazil.
,
Thiago Yoshinaga Tonholo Silva 
1   Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Neurologia e Neurocirurgia, Unidade de Ataxias, São Paulo SP, Brazil.
,
Raphael Pinheiro Camurugy da Hora 
1   Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Neurologia e Neurocirurgia, Unidade de Ataxias, São Paulo SP, Brazil.
,
Orlando Graziani Povoas Barsottini 
1   Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Neurologia e Neurocirurgia, Unidade de Ataxias, São Paulo SP, Brazil.
,
José Luiz Pedroso 
1   Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Neurologia e Neurocirurgia, Unidade de Ataxias, São Paulo SP, Brazil.
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Abstract

Background

The rates of complications after major abdominal surgeries remain high, despite the advances in pre- and postoperative care and surgical techniques. In these cases, neurological disorders mainly include stroke and delirium, with a high increase of morbidity. Ataxia is rarely a consequence of abdominal procedures like, more often being related to long-term complications of bariatric surgery due to chronic vitamin deficiency.

Objective

To describe seven cases of ataxia following major abdominal surgeries and propose a prophylactic approach.

Methods

A retrospective case series in which medical records of patients from the Ataxia Unit of Universidade Federal de São Paulo were evaluated from January 2007 to August 2024. We identified seven patients who developed acute cerebellar ataxia after gastrointestinal surgery. Demographic, clinical, laboratory, neuroimaging, and treatment data were extracted. Descriptive statistics was used to summarize findings.

Results

There were two cases that evolved with neurological improvement, and five remained with severe cerebellar ataxia. Brain imaging showed cerebellar atrophy in three patients and signs of Wernicke encephalopathy in two.

Conclusion

This case series describes an unusual form of acute ataxia with poor outcomes, possibly related to complications from major abdominal surgery. Early intervention and prophylactic supplementation with vitamins B1 and B12 in patients receiving TPN should be considered to avoid such severe neurological complications.

Keywords

Postoperative Complications - Ataxia - Bariatric Surgery - Avitaminosis

Authors' Contributions

Conceptualization: VRP, TYTS, JLP; Data curation: TYTS; Methodology: TYTS; Project administration: OGPB, JLP; Writing – review & editing: TYTS, RPCH, OGPB, JLP.


Data Availability Statement

All relevant data are included in the article and in the Supplementary Appendix.


Editor-in-Chief: Hélio A. G. Teive (https://orcid.org/0000-0003-2305-1073).


Associate Editor: Renato Puppi Munhoz (https://orcid.org/0000-0002-4783-4067).




Publication History

Received: 12 February 2025

Accepted: 28 April 2025

Article published online:
15 July 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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Bibliographical Record
Victor Rebelo Procaci, Thiago Yoshinaga Tonholo Silva, Raphael Pinheiro Camurugy da Hora, Orlando Graziani Povoas Barsottini, José Luiz Pedroso. Clinical characterization, natural history, and neuroimaging of cerebellar ataxia after abdominal surgery. Arq Neuropsiquiatr 2025; 83: s00451809934.
DOI: 10.1055/s-0045-1809934