Spontaneous Intracranial Epidural Hematoma Originating from Dural Metastasis of Hepatocellular Carcinoma.
10.3340/jkns.2010.48.2.166
- Author:
Byoung Gu KIM
1
;
Seok Mann YOON
;
Hack Gun BAE
;
Il Gyu YUN
Author Information
1. Department of Neurosurgery, Soonchunhyang University Cheonan Hospital, Cheonan, Korea. smyoon@sch.ac.kr
- Publication Type:Case Report
- Keywords:
Spontaneous epidural hematoma;
Hepatocellular carcinoma;
Dural metastasis
- MeSH:
Anisocoria;
Brain;
Carcinoma, Hepatocellular;
Cranial Fossa, Middle;
Craniotomy;
Decerebrate State;
Floors and Floorcoverings;
Hematoma, Epidural, Cranial;
Hemorrhage;
Humans;
Male;
Middle Aged;
Neoplasm Metastasis;
Neurosurgery
- From:Journal of Korean Neurosurgical Society
2010;48(2):166-169
- CountryRepublic of Korea
- Language:English
-
Abstract:
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.
