Leptomeningeal metastasis from melanoma emulating chronic subdural hematoma: a case report

Abstract Background Melanoma is a disease in which the patient doesn’t know about the primary lesion, and it has a propensity to metastases to any organ in the human body. Amongst melanoma, leptomeningeal metastasis has the least incidence. Case presentation In this case, we report a 56-year-old lady presenting with headache, recurrent vomiting and slurring of speech which on imaging was suggestive of chronic subdural hematoma which had led to surgical preparation but upon further examination, and radioimaging was found to be leptomeningeal metastasis from melanoma for which systemic therapy was started. Conclusions The concern is vigilance that is much needed in any case presenting in emergency. When the diagnosis is chronic subdural hematoma, it is followed by surgical treatment which is not done for leptomeningeal metastasis.

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Combined dural inversion with multiple burr holes for refractory chronic subdural hematoma: A case report.

10.21203/rs.3.rs-361493/v1 ◽

2021 ◽

Author(s):

Tuo Li ◽

wei zhu ◽

Hongying Hao ◽

Hongguang Chen ◽

Jianning Zhang

Keyword(s):

Case Report ◽

Subdural Hematoma ◽

Chronic Subdural Hematoma ◽

Common Disease ◽

Parietal Region ◽

Local Hospital ◽

Case Presentation ◽

Surgical Method ◽

Burr Holes ◽

Multiple Holes

Abstract Background: Chronic subdural hematoma（CSDH） is a common disease in neurosurgery department. Burr-hole drainage is the main surgical treatment. And the recurrence rate is as high as 25%.Case presentation: In this case, a male patient with CSDH in the left frontotemporal parietal region underwent two drilling and drainage operations in the local hospital, but the hematoma recurred after operations. Being unable to bearing the repeated and progressive aggravation of headache, he came to our hospital for treatment. After considering the comprehensive situation, we use a new surgical method, removal of hematoma by drilling multiple holes in the lateral skull, to cure the patient.Conclusions: we get inspirations from the therapy for moyamoya disease, combining dura mater inversion and hole burr, the scalp forms many "meat column" like structures which have powerful capability in absorption through the bone holes, so the scalp could deep into the hematoma, then the CSDH could be cured. This case Provide a new surgical method for the treatment of refractory CSDH. Key words: CSDH R ecur Bone hole Scalp Dural mater inversion

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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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