Chronic Encapsulated Intracerebral Hematoma Associated with Angiographically Occult Arteriovenous Malformation —Case Report—

The authors report a rare case of a patient with a chronic encapsulated expanding hematoma and progressive neurological deterioration who presented 2 years after gamma knife radiosurgery for a cerebral arteriovenous malformation (AVM). A tough capsule containing multiple layers of organized hematoma resulting from previous bleeding was confirmed surgically. Histological examination revealed that the capsule consisted of a dense collagenous outer layer and a granulomatous newly vascularized inner layer with marked fibrosis. Hemosiderin deposits were frequently observed in the inner layer, which suggested recurrent minor bleeding from fragile vessels in this layer. An AVM was found in the hematoma, which had degenerated as the result of radiosurgery. A cross-section of the abnormal vessels showed various stages of obliteration due to intimal hypertrophy. The clinical course, radiological features, and histological findings in this case were compatible with those of previously reported chronic encapsulated hematomas. A possible mechanism of hematoma formation and its expansion are discussed.

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“…We believe surgical extirpation is the only way to treat this type of bleeding. [1][2][3]5,7,9,10,[13][14][15][16][17][18][19][20][21]25 …”

Section: Discussionmentioning

confidence: 99%

Chronic encapsulated expanding hematoma in association with gamma knife stereotactic radiosurgery for a cerebral arteriovenous malformation

Kurita

Sasaki²,

Kawamoto³

et al. 1996

Journal of Neurosurgery

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“…To date, 54 other cases have been reported in the literature. [1234567891011121314151617181920212223242526272829303132333435363738394041424344] Table 1 depicts background characteristics and details of the patients. CEIH is a disease affecting all ages; the youngest reported patient was 2 months old and the oldest was 80 years old.…”

Section: Discussionmentioning

confidence: 99%

Chronic encapsulated intracerebral hematoma: Three case reports and a literature review

Nishiyama¹,

Toi²,

Takai³

et al. 2014

Surg Neurol Int

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Background:Chronic encapsulated intracerebral hematoma (CEIH) is one type of intracerebral hematoma that sometimes grows progressively while forming a capsule and presenting with neurological deficits. Although many cases of CEIH have been reported, correct preoperative diagnosis is very difficult. Only around 20% of cases are diagnosed preoperatively.Case Description:We encountered three cases of CEIH in which causes were unidentified and difficult to diagnose. All three cases were treated surgically. In the first case, a 59-year-old male was diagnosed preoperatively with metastatic brain tumor. In the second case, a 62-year-old female was diagnosed preoperatively with glioblastoma. The third case involved a 58-year-old female diagnosed preoperatively with CEIH.Conclusion:We should keep in mind that CEIH is a differential diagnosis for intracerebral space-occupying lesions. This report describes these three cases and discusses imaging findings and characteristics of CEIH.

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“…CEIH is a special type of intracerebral hematoma described for the first time in 1981, 10) with about 50 cases reported. [1][2][3][4][5][6][7][8][9][10][11][12]14,16,[18][19][20][21][22][23][24][25][26][27][28][29][31][32][33][34][35][36] Compared with normal intracerebral hemorrhage, CEIH is characterized by early age of onset and rare complication by hypertension, and almost all such lesions have developed beneath the cerebral cortex. 12) Headaches and seizures are the most common earliest symptoms.…”

Section: Discussionmentioning

confidence: 99%

Chronic Encapsulated Intracerebral Hematoma Associated With Cavernous Angioma -Case Report-

Miyahara

Fujitsu

Yagishita

et al. 2011

Neurol. Med. Chir.(Tokyo)

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An 80-year-old male presented with a chronic encapsulated intracerebral hematoma (CEIH) with surrounding edema under the right frontal lobe manifesting as slow exacerbation of disturbance of orientation and gait. He had a history of cerebral infarction with an asymptomatic cavernous angioma in the right frontal lobe. The CEIH was diagnosed as bleeding from the cavernous angioma, and surgical removal was performed. The hematoma was chronic and covered by a thick capsule. In addition, mass tissue covered with the organized hematoma was found near the capsule, which was excised and found to be a cavernous angioma. CEIH is a special type of intracerebral hemorrhage, and bleeding from a cavernous angioma is occasionally seen. CEIH should be considered in the case of a hemorrhagic intracranial lesion with a chronic, progressive course with capsule formation and edema around the lesion. The source of bleeding is unknown in about half of the reported cases, and occult vascular malformation may be involved, necessitating care in diagnosis.

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Chronic Encapsulated Intracerebral Hematoma Associated with Angiographically Occult Arteriovenous Malformation —Case Report—

Abstract: A 34-year

Cited by 26 publications

References 19 publications

Chronic encapsulated expanding hematoma in association with gamma knife stereotactic radiosurgery for a cerebral arteriovenous malformation

Chronic encapsulated expanding hematoma in association with gamma knife stereotactic radiosurgery for a cerebral arteriovenous malformation

Chronic encapsulated intracerebral hematoma: Three case reports and a literature review

Chronic Encapsulated Intracerebral Hematoma Associated With Cavernous Angioma -Case Report-

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