Acute Traumatic Subdural Hematoma Originating from a Convexity Meningioma —Case Report—

Moriyama, Eiji; Beck, Hiroichi; Takayama, Kazuhiro; Okamoto, Tsukasa

doi:10.2176/nmc.38.20

Cited by 13 publications

(7 citation statements)

References 16 publications

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“…Angiomatous meningiomas tend to bleed because of its thin-walled vessels and rich vasculature. 2 , 15) Thus, abnormal intratumoral vessels might be ruptured and cause intratumoral hemorrhage, secondarily leading to subdural hematoma in this case.…”

Section: Discussionmentioning

confidence: 78%

“…3 , 4) Most of hemorrhage from meningiomas presented as subarachnoid hemorrhage, intracerebral hemorrhage or intratumoral hemorrhage. 2 – 4) Subdural hemorrhage is uncommon: especially acute or subacute interhemispheric subdural hematoma is rare, and only four cases were reported including our case ( Table 1 ). 7 – 9) To be associated with interhemispheric subdural hematoma, meningioma should be located in a parasagittal region or on the falx.…”

Section: Discussionmentioning

confidence: 78%

“… 1) The most common type of bleeding is subarachnoid hemorrhage, followed by intracerebral hemorrhage and intratumoral hemorrhage. 2 – 4) Subdural hemorrhage from meningiomas is uncommon, especially along the falx. 5 – 7) We here report a rare case of tiny falx meningioma presenting as massive interhemispheric subdural hematoma, initially of unknown origin, and review the literature.…”

Section: Introductionmentioning

confidence: 99%

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Tiny Falx Meningioma Causing Massive Interhemispheric Subdural Hematoma: A Case Report

Suzuki

Fujimoto²,

Kawakita³

et al. 2018

NMC Case Report Journal

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Bleeding from meningiomas is well known, but massive subdural hemorrhage from a very small meningioma is rare. A 61-year-old woman presented with a sudden-onset headache and slight right hemiparesis without a history of trauma. Computed tomographic scan showed bilateral acute/subacute interhemispheric subdural hematoma, but contrast-enhanced computed tomography (CT) scan, non-enhanced magnetic resonance imaging (MRI) and digital subtraction angiography failed to detect the cause. The hematoma was conservatively treated. Three weeks later, CT scans showed a vestige of the hematoma along the falx. However, repeated angiogram revealed a tumor stain on the falx supplied by the middle meningeal arteries, leading to the tentative diagnosis of meningioma. The tumor was removed and histologically diagnosed as angiomatous meningioma. It is rare that falx meningioma causes massive interhemispheric subdural hematoma, and the diagnosis of the causative lesion is challenging if tumor is small. We review the literature and discuss the characteristics.

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Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 78%

Section: Introductionmentioning

confidence: 99%

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Tiny Falx Meningioma Causing Massive Interhemispheric Subdural Hematoma: A Case Report

Suzuki

Fujimoto²,

Kawakita³

et al. 2018

NMC Case Report Journal

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“…In literature, acute SDHs have been associated with both spontaneous (i.e., caused by aneurysm, coagulation deficits) [25][26][27] and traumatic causes in patients affected by tumors, like meningioma, which bled after trauma [28]. Unlike those already reported, our case presented a massive acute EDH on the left and a small acute SDH on the right, clearly caused by trauma and brain decompression after the evacuation of the contralateral concomitant EDH/SDH, without bleeding from the meningioma itself.…”

Section: Case Illustrationmentioning

confidence: 99%

Delayed Bilateral, Post-Traumatic Extra-Subdural Hematomas in a Patient with Meningioma

Umana¹,

Ferini²,

Crea³

et al. 2022

Oncologie

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Concomitant acute epidural hematoma (EDH) and subdural hematoma (SDH) is a rare finding, and its bilateral onset has not yet been reported in literature. We present the first report of a patient affected by post-traumatic concomitant EDH and SDH, with the contralateral, delayed onset of another, associated with meningioma previously treated with gamma knife. A 60-year-old female patient with a history of simple focal seizures with motor symptoms and well-controlled by drugs since childhood, arterial hypertension, and incidental diagnosis of multiple meningiomas was referred to our department after falling down the stairs. Initially, the patient was prescribed gamma knife treatment of the right frontal convexity meningioma. The patient was admitted to our emergency department with Glasgow Coma Scale (GCS) score of 7/15 and isochoric, myotic pupils. An immediate head CT scan revealed a small acute SDH in the right hemisphere and an acute blood collection in the left hemisphere, which exerted mass effect; furthermore, we discovered complex skull fractures across the superior sagittal sinus, and dislocated bone fragments. A left decompressive craniectomy was performed, and intraoperatively we observed a concomitant EDH/SDH. Due to the patient's anisocoria, an urgent postoperative CT scan was performed, revealing a massive blood collection in the right hemisphere, which was discovered to be another concomitant EDH/SDH, during right trauma flap. Through this approach, we also removed the right frontal convexity meningioma. After 5 days in the intensive care unit (ICU), the patient died because she presented an acute heart failure. The development of a contralateral, delayed EDH/SDH must be considered in severe traumatic patients, especially if associated fractures across major dural sinuses are present. Intraoperative CT scan, if available, or immediate postoperative CT scan, is mandatory for adequate management of complex neurotrauma cases.

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“…Postmortem examination may reveal bleeding from an intracranial tumor, including meningioma. In 1998, Moriyama et al (42) reported the first case of subdural hematoma originating from a meningioma. Recently, Vij et al (43) proposed that mild head trauma can stretch and break the bridging veins overlying a slow growth parasagittal or convexity-based meningiomas resulting in subdural bleeding.…”

Section: Spontaneous Intratumoral Hemorrhagementioning

confidence: 99%

Sudden Unexpected Deaths Due to Intracranial Meningioma: Presentation of Six Fatal Cases, Review of the Literature, and A Discussion of the Mechanisms of Death

Gitto

Bolino

Cina³

2017

Journal of Forensic Sciences

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Deaths due to meningiomas are routinely diagnosed in clinical practice because this neoplasm tends to present with the typical progression of neurological deficits. On the other hand, sudden unexpected deaths due to meningiomas are rarely described in the literature. The study presents six fatal cases of previously undiagnosed intracranial meningiomas from the Cook County Medical Examiner's Office from 1998 to 2014. The most common explanation of the mechanism of sudden death due to intracranial neoplasms is a rapid increase in intracranial pressure produced by the mass effect of the neoplasm. Other mechanisms of death include acute intracranial and intratumoral hemorrhage, and benign neoplasms that grow in the vicinity of vital centers altering neural discharge in autonomic pathways leading to cardiac suppression or lethal arrhythmia. Forensic pathologists must keep in mind that sudden unexpected death caused by intracranial meningiomas, although extremely rare, may be encountered in the forensic setting.

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Acute Traumatic Subdural Hematoma Originating from a Convexity Meningioma —Case Report—

Abstract: A 68-year

Cited by 13 publications

References 16 publications

Tiny Falx Meningioma Causing Massive Interhemispheric Subdural Hematoma: A Case Report

Tiny Falx Meningioma Causing Massive Interhemispheric Subdural Hematoma: A Case Report

Delayed Bilateral, Post-Traumatic Extra-Subdural Hematomas in a Patient with Meningioma

Sudden Unexpected Deaths Due to Intracranial Meningioma: Presentation of Six Fatal Cases, Review of the Literature, and A Discussion of the Mechanisms of Death

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