RESUMO
Spontaneous intracranial epidural hematoma (EDH) due to dural metastasis of hepatocellular carcinoma is very rare. A 53-year-old male patient with hepatocellular carcinoma, who was admitted to the department of oncology, was referred to department of neurosurgery because of sudden mental deterioration to semicoma with papillary anisocoria and decerebrate rigidity after transarterial chemoembolization for hepatoma. Brain computed tomography (CT) revealed large amount of acute EDH with severe midline shifting. An emergent craniotomy and evacuation of EDH was performed. Active bleeding from middle cranial fossa floor was identified. There showed osteolytic change on the middle fossa floor with friable mass-like lesion spreading on the overlying dura suggesting metastasis. Pathological examination revealed anaplastic cells with sinusoidal arrangement which probably led to spontaneous hemorrhage and formation of EDH. As a rare cause of spontaneous EDH, dural metastasis from malignancy should be considered.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Anisocoria , Encéfalo , Carcinoma Hepatocelular , Fossa Craniana Média , Craniotomia , Estado de Descerebração , Pisos e Cobertura de Pisos , Hematoma Epidural Craniano , Hemorragia , Metástase Neoplásica , NeurocirurgiaRESUMO
The authors report a case of nontraumatic subdural hematoma associated with dural metastasis. We review the pathological and hematological features of this and 13 similar cases reported in the literature. Although rare, they have different pathological and hematological features. According to the pathological features, three types are subclassified and the presumptive pathogeneses are discussed.
Assuntos
Hematoma Subdural , Metástase NeoplásicaRESUMO
The spontaneous subdural hematoma due to dural metastasis is a rare events. It is suggested that disseminated intravascular coagulation(DIC) and vascular obstruction due to invasion of the dural vessel play the important factors in the formation of the subdural hematoma in cancer patient. The authors presented 5 cases with a review of the literature.