Encapsulated Unresolved Subdural Hematoma Mimicking Acute Epidural Hematoma: A Case Report.
10.13004/kjnt.2014.10.2.142
- Author:
Sang Soo PARK
1
;
Woo Ram SHIN
;
Hyo Joon KIM
;
Chang Young KWON
Author Information
1. Department of Neurosurgery, Presbyterian Medical Center, University of Seonam College of Medicine, Jeonju, Korea. hisarang@hanmail.net
- Publication Type:Case Report
- Keywords:
Hematoma epidural cranial;
Hematoma subdural acute;
Hematoma;
Cerebral hemorrhage
- MeSH:
Aged, 80 and over;
Cerebral Hemorrhage;
Diagnosis, Differential;
Emergencies;
Hematoma*;
Hematoma, Subdural*;
Hematoma, Subdural, Acute;
Humans;
Skull;
Subdural Space;
Tomography, X-Ray Computed
- From:Korean Journal of Neurotrauma
2014;10(2):142-145
- CountryRepublic of Korea
- Language:English
-
Abstract:
Encapsulated acute subdural hematoma (ASDH) has been uncommonly reported. To our knowledge, a few cases of lentiform ASDH have been reported. The mechanism of encapsulated ASDH has been studied but not completely clarified. Encapsulated lentiform ASDH on a computed tomography (CT) scan mimics acute epidural hematoma (AEDH). Misinterpretation of biconvex-shaped ASDH on CT scan as AEDH often occurs and is usually identified by neurosurgical intervention. We report a case of an 85-year-old man presenting with a 2-day history of mental deterioration and right-sided weakness. CT scan revealed a biconvex-shaped hyperdense mass mixed with various densities of blood along the left temporoparietal cerebral convexity, which was misinterpreted as AEDH preoperatively. Emergency craniectomy was performed, but no AEDH was found beneath the skull. In the subdural space, encapsulated ASDH was located. En block resection of encapsulated ASDH was done. Emergency craniectomy confirmed that the preoperatively diagnosed AEDH was an encapsulated ASDH postoperatively. Radiologic studies of AEDH-like SDH allow us to establish an easy differential diagnosis between AEDH and ASDH by distinct features. More histological studies will provide us information on the mechanism underlying encapsulated ASDH.
