Department of Neurosurgery, Mayo Clinic, Rochester, MN 55905, USA.
Neurocrit Care. 2012 Feb;16(1):148-50. doi: 10.1007/s12028-011-9631-7.
Subdural hematomas are not infrequent among patients with hematologic disorders as they are prone to thrombocytopenia from their disease and chemotherapy. However, rarely these patients can also have leukemic involvement of the subdural space.
Case Report with CT scan and intraoperative photographs.
A 45-year-old woman with acute myeloid leukemia presented with progressive headache, somnolence, and hemiparesis. She was noted to be thrombocytopenic. CT scan revealed a heterodense extra-axial lesion consistent with an acute to subacute subdural hematoma. There was no antecedent trauma. After platelet transfusion, she was taken for burr hole evacuation and an opalescent pearly white mass was encountered. Pathology revealed myeloid sarcoma.
Myeloid sarcoma can mimic subdural hematoma both clinically and radiologically. It should be considered when a patient with a prior leukemia and no antecedent trauma presents with an extra-axial lesion.
患有血液疾病的患者容易因疾病和化疗导致血小板减少，因此硬膜下血肿并不少见。然而，这些患者的硬膜下腔也很少会发生白血病浸润。
病例报告并附有 CT 扫描和术中照片。
一名 45 岁女性患有急性髓细胞性白血病，表现为进行性头痛、嗜睡和偏瘫。她被发现血小板减少。CT 扫描显示一个异密度的外轴病变，符合急性至亚急性硬膜下血肿。没有先前的创伤。血小板输注后，她接受了颅骨钻孔清除术，遇到了乳白色的珍珠白色肿块。病理显示髓样肉瘤。
髓样肉瘤在临床和影像学上均可模拟硬膜下血肿。当有先前白血病且无先前创伤的患者出现外轴病变时，应考虑髓样肉瘤。
