Mirsadeghi Seyed Mohammad Haji, Habibi Zohreh, Meybodi Keyvan Tayebi, Nejat Farideh, Tabatabai Seyed Ali Fakhr
Department of Neurosurgery, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Cases J. 2008 Nov 18;1(1):328. doi: 10.1186/1757-1626-1-328.
Subdural effusion in the setting of dural metastasis is very rare and may be difficult to be distinguished from chronic subdural hematoma.
A 44-year old woman with gastric adenocarcinoma was presented with headache and a hypodense subdural collection in right fronto-parietal in brain CT. Burr-hole irrigation was performed with the impression of chronic subdural hematoma, but nonhemorrhagic xantochromic fluid was evacuated without malignant cell. Brain CT on the 11th day depicted fluid re-accumulation and noticeable midline shift, necessitating craniotomy and removing the affected dura.
Because the affected dura can be supposed as the main source of subdural effusion, resection of the involved dura is obligatory for the appropriate palliative management of such patients.
硬脑膜转移瘤患者出现硬膜下积液极为罕见，且可能难以与慢性硬膜下血肿相鉴别。
一名44岁胃腺癌女性患者，因头痛就诊，脑部CT显示右侧额顶叶有一低密度硬膜下积液。最初按慢性硬膜下血肿行钻孔冲洗引流术，但引出的是非血性黄色液体，未发现恶性细胞。术后第11天脑部CT显示积液再次积聚且中线明显移位，需行开颅手术并切除受累硬脑膜。
鉴于受累硬脑膜可能是硬膜下积液的主要来源，对于此类患者，切除受累硬脑膜是合适的姑息治疗措施。
