Spontaneous Epidural Hematoma from Skull Base Metastasis of Hepatocellular Carcinoma

Woo, Kwang Moo; Kim, Byong-Cheol; Cho, Keun-Tae; Kim, Eo-Jin

doi:10.3340/jkns.2010.47.6.461

Cited by 23 publications

(22 citation statements)

References 11 publications

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“…The development of spontaneous AEDH from metastatic HCC of the skull is extremely rare, and only 6 cases have been previously reported in the literature (3)(4)(5)(6)8,9). The present study reports the case of a patient with spontaneous AEDH that developed from a skull metastasis of HCC, and the clinical presentation and pathogenesis are discussed with a review of the literature.…”

Section: Introductionmentioning

confidence: 90%

“…First, HCC contains numerous sinusoid-like vessels, and the fragility of these vessels may lead to hemorrhage and the formation of the epidural hematoma (3)(4)(5)(6)8,9). Second, coagulopathy caused by hepatic dysfunction may increase the risk of tumor bleeding (3,5,6,9). Third, the destructive growth of metastatic HCC may lead to the breakdown of the vessel structures in the peritumoral tissue, as demonstrated in osteolytic change (5,6,8).…”

Section: Discussionmentioning

confidence: 99%

“…Spontaneous AEDH of skull metastases from HCC is a rare condition, and only 6 cases have been previously reported in the literature (Table I) (3)(4)(5)(6)8,9). Based on the review of the cases, the majority of AEDH patients experience a severe headache followed by neurological deficits, including the deterioration of consciousness or hemiparesis (3,4,6,8,9).…”

Section: Discussionmentioning

confidence: 99%

“…However, several characteristics of HCC may contribute to intracranial bleeding. First, HCC contains numerous sinusoid-like vessels, and the fragility of these vessels may lead to hemorrhage and the formation of the epidural hematoma (3)(4)(5)(6)8,9). Second, coagulopathy caused by hepatic dysfunction may increase the risk of tumor bleeding (3,5,6,9).…”

Section: Discussionmentioning

confidence: 99%

“…Third, the destructive growth of metastatic HCC may lead to the breakdown of the vessel structures in the peritumoral tissue, as demonstrated in osteolytic change (5,6,8). Fourth, injury of the main feeders from the external carotid artery or the surrounding venous structures, induced by a trivial accident, may be involved (5,6,8).…”

Section: Discussionmentioning

confidence: 99%

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Spontaneous acute epidural hematoma developed due to skull metastasis of hepatocelluar carcinoma: A case report and review of the literature

et al. 2015

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Abstract. Acute epidural hematoma (AEDH) is one of the most common pathological types of head trauma, and may develop without an accidental event, although this is uncommon. The present study reports the case of a 41-year-old male patient that developed spontaneous AEDH due to skull metastasis of hepatocellular carcinoma (HCC). The man was admitted to Chonnam National University Hwasun Hospital and Medical School due to drowsiness and right-sided hemiparesis. A computed tomography scan of the head revealed the presence of a large AEDH and a lytic bone lesion in the left posterior fossa and parieto-occipital region, which exhibited heterogeneous enhancement. The perioperative findings revealed a large amount of mixed-stage epidural hematoma and a soft hemorrhagic mass that exhibited lytic change on the occipital bone. No evidence of head trauma, such as skull fracture or scalp contusion, was detected. The pathological diagnosis was hematoma with metastatic HCC. The current study reports the rare case of a patient with a metastatic tumor located in the skull that resulted in the development of spontaneous AEDH. Once a sudden and unpredicted neurological deficit occurs in a patient with HCC that is also diagnosed with skull metastasis, the possibility of spontaneous AEDH developing from the metastasis should be considered.

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