Spinal chronic subdural hematoma in a patient with ventriculo-peritoneal shunting after a minor trauma

External hydrocephalus has been associated with subdural hematomas in infancy, and the hematomas have been noted to be secondary to minor trauma or have even been described as spontaneous. The author reports the case of an infant with external hydrocephalus who developed retinal as well as subdural hemorrhages after sustaining a minor head injury. Although retinal hemorrhage in infancy has been considered virtually pathognomonic of child abuse, in the setting of external hydrocephalus a more cautious interpretation may be appropriate.

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Imaging differentiation on extra-axial fluid collections: a clinical Image.

Archives of Pediatric Neurosurgery ◽

10.46900/apn.v3i3(september-december).96 ◽

2021 ◽

Vol 3 (3(September-December)) ◽

pp. e962021

Author(s):

Felipe Gutierrez Pineda

Keyword(s):

Subdural Hematoma ◽

Brain Mri ◽

Chronic Subdural Hematoma ◽

Clinical Image ◽

Minor Trauma ◽

Altered Level ◽

Normal Delivery ◽

Cortical Vein ◽

External Hydrocephalus ◽

Fluid Collections

A 3 month – old male patient with a history of seizures presents to the Pediatric neurosurgery department with his parents, on initial evaluation a head circumference of 47.5 cm (> percentile 99 on the WHO chart) was seen. A brain MRI was performed and an extra axial fluid collections (Chronic subdural hematoma and benign external hydrocephalus) was diagnosed. His parents refer a normal delivery without any complication and the medical history and records denied any previous trauma. A neurosurgical evacuation of the subdural hematoma was performed, and a complete improvement of his seizure was seen on 3 months follow up. Benign external hydrocephalus (BEH) has been proposed as a risk factor for the presence of chronic subdural hematoma (SDH) in infants (1). The SDH formation in the presence of BEH has been reported to be a venous rupture either spontaneously or following minor trauma from the bridging veins traversing the subdural/subarachnoid space (Red arrow , image D ) that are stretched with enlarged extra?axial collections (2). Epidemiologically there are striking similarities between these entities (3) that can be differentiated by some MRI findings.The signs that help us in the differentiation are: the subarachnoid layer visible (yellow arrow image B, showing a displaced subarachnoid layer downward by a fluid between it and the dura) the absence of the cortical vein sign and the differential on fluid intensity on T1-T2 weighted images (Images A,B,C,D) (4). Surgery evacuation is necessary for the patients with chronic subdural hematoma associated with BEH and neurological signs of increased intracranial pressure like macrocrania, seizures and altered level of consciousness (Image F , showing the subdural space without hematoma and the subarachnoid layer downward it ) (5).

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Current Clinical Standards for the Treatment of Chronic Subdural Hematoma in Austrian, German, and Swiss Neurosurgical Units

10.1055/s-0038-1660763 ◽

2018 ◽

Author(s):

D. Baschera ◽

L. Tosic ◽

L. Westermann ◽

J. Oberle ◽

A. Alfieri

Keyword(s):

Subdural Hematoma ◽

Chronic Subdural Hematoma ◽

Clinical Standards

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Bilateral Acute Subdural Hematoma Following Evacuation of Chronic Subdural Hematoma

Journal of Korean Neurosurgical Society ◽

10.3340/jkns.2007.41.4.267 ◽

2007 ◽

Vol 41 (4) ◽

pp. 267 ◽

Cited By ~ 4

Author(s):

Seok Won Kim ◽

Seung Myung Lee ◽

Ho Shin

Keyword(s):

Subdural Hematoma ◽

Chronic Subdural Hematoma ◽

Acute Subdural Hematoma

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Independent predictors for functional outcome after drainage of chronic subdural hematoma identified using a logistic regression model

Journal of Neurosurgical Sciences ◽

10.23736/s0390-5616.17.04056-5 ◽

2020 ◽

Vol 64 (2) ◽

Cited By ~ 2

Author(s):

Sotirios Katsigiannis ◽

Christina Hamisch ◽

Boris Krischek ◽

Marco Timmer ◽

Anastasios Mpotsaris ◽

...

Keyword(s):

Logistic Regression ◽

Regression Model ◽

Functional Outcome ◽

Subdural Hematoma ◽

Logistic Regression Model ◽

Chronic Subdural Hematoma

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Meningeal Carcinomatosis for Prostate Adenocarcinoma Mimicking Chronic Subdural Hematoma: Case Report and Literature Review

Arquivos Brasileiros de Neurocirurgia Brazilian Neurosurgery ◽

10.1055/s-0040-1713092 ◽

2021 ◽

Author(s):

Tiago Silva Holanda Ferreira ◽

Gilnard Caminha de Menezes Aguiar ◽

Daniel Gurgel Fernandes Távora ◽

Lucas Alverne Freitas de Albuquerque ◽

Stélio da Conceição Araújo Filho

Keyword(s):

Case Report ◽

Subdural Hematoma ◽

Specific Antigen ◽

Chronic Subdural Hematoma ◽

Radical Resection ◽

Prostate Adenocarcinoma ◽

Meningeal Carcinomatosis ◽

Motor Deficits ◽

Friable Material ◽

The Central Nervous System

Abstract Introduction Cerebral metastases are the most common cancer of the central nervous system (CNS). Meningeal infiltration by neoplasms that did not originate in the CNS is a rare fact that is present in 0.02% of the autopsies.Epidemiologically, the radiological presentation mimicking a subdural hematoma is even more uncommon. We report a case of meningeal carcinomatosis by an adenocarcinoma of the prostate mimicking a chronic subdural hematoma. Case Report A 60-year-old male patient was diagnosed with prostate cancer in 2011. He underwent radical resection of the prostate, as well as adjuvant hormonal therapy and chemotherapy.Five years later, the patient presented peripheral facial paralysis that evolved with vomiting and mental confusion. Tomography and magnetic resonance imaging scans confirmed the subdural collection.At surgery, the dura was infiltrated by friable material of difficult hemostasis. The anatomicopathological examination showed atypical epithelial cells. The immunohistochemistry was positive for prostate-specific antigen (PSA) and other key markers, and it was conclusive for meningeal carcinomatosis by a prostate adenocarcinoma. Discussion Meningeal carcinomatosis presents clinically with headache, motor deficits, vomiting, changes in consciousness and seizures.The two most discussed mechanisms of neoplastic infiltration are the hematogenous route and retrograde drainage by the vertebral venous plexus. Conclusion Variable clinical presentations may occur in dural metastases; however, the radiological presentation as subdural hematoma is rare. There are few descriptions of cases like this one in the literature.To support the diagnosis, the previous medical history is as important as the complementary exams and the radiological findings, because the symptoms are common at the neurological emergency. To our knowledge, this is the first report of a prostate neoplasm mimicking chronic subdural hematoma in Brazil.

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