Acute interdural hematoma mimicking epidural hematoma: a case report

Abstract

Intracranial hematoma rarely presents between two dural layers of pachimeninges. Here, we present a case of an interdural hematoma with similar appearance to an epidural hematoma. A 51-year-old man presented with a left temporal contusion following a motor vehicle accident. After craniotomy and contusion removal, the post-operative CT scan showed a parietal intracranial hematoma located posterior and superior to the bone flap. The CT scan appearance of the new hematoma was similar to the CT scan appearance of an epidural hematoma. Upon operation, we determined that the hematoma was located between two layers of dura mater, i.e., an interdural hematoma. We removed the hematoma and sutured the two layers of dura to each other at multiple sites. Interdural hematoma is a rare entity. Its appearance in a CT scan can be mistaken for an extradural hematoma.

A blackhole over brain: Interdural hematoma – A challenging diagnosis

“…Although CT is valuable for diagnosis of intracranial hematoma, it has not found to be valid in diagnosing interdural hematoma [2,3,5,6]. Bartoli et al [2] mentioned that CT misled them to a pre-operative diagnosis of subdural hematoma, whereas Eom et al [5] and Baharvahdat et al [6] made a pre-diagnosis of epidural hematoma depending on what they had seen on CT.…”

“…Bartoli et al [2] mentioned that CT misled them to a pre-operative diagnosis of subdural hematoma, whereas Eom et al [5] and Baharvahdat et al [6] made a pre-diagnosis of epidural hematoma depending on what they had seen on CT. Magnetic resonance imaging will be more useful than CT even though it may still not fully depict the exact location and nature of the hematoma [3].…”

“…Inter-or intradural hematoma is mostly observed in infants and stillborns (13%), yet rare in adulthood (5 previous patients) ( Table 1) [1][2][3][4][5][6]. The reason for high prevalence in infancy is due to dura composition in early life.…”

“…Falx and tentorium for infants, skull base for adult patients with aneurysm rupture, cranial convexity for adult patients without any vascular lesion are common locations for interdural hematomas [1][2][3]5,6,12].…”

“…Incidence has been reported as much as 13% in a postmortem study of stillborns and deceased life-birth infants [4]. However, only 5 adult patients with interdural hematoma have been presented, so far (Table 1) [1][2][3]5,6]. We are reporting a 61-yearold male patient with alcoholic cirrhosis, who developed interdural hematoma spontaneously.…”