Schmitt Anne J, Mitha Alim P, Germain Rasha, Eschbacher Jennifer, Spetzler Robert F
Department of Neurosurgery, John Radcliffe Hospital, Oxford, United Kingdom.
Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.
World Neurosurg. 2014 Sep-Oct;82(3-4):535.e1-3. doi: 10.1016/j.wneu.2013.01.018. Epub 2013 Jan 10.
To present a case of a cavernous malformation presenting with a subdural hematoma.
A 27-year-old woman was admitted with progressively worsening headache, vomiting, weakness, and word-finding difficulties 1 week after she was discharged from an outside hospital, where she was managed conservatively for a presumed traumatic subdural hematoma. Computed tomography revealed an enlarging subacute left hemispheric subdural hematoma for which she underwent drill craniostomy. Postprocedural magnetic resonance imaging showed a posterior left temporal lobe mass consistent with a cavernous malformation juxtaposed with the subdural hematoma. Craniotomy for resection of the lesion was performed. She had an uncomplicated postoperative course and experienced a good recovery.
The signs and symptoms, diagnostic imaging, and intraoperative findings suggest that the subdural hematoma was caused by extralesional hemorrhage of the cavernous malformation, which is a rare finding associated with these malformations.
The clinical course, radiologic, and intraoperative findings suggest that the subdural hemorrhage was caused by extralesional hemorrhage of the cavernous malformation.
报告一例表现为硬膜下血肿的海绵状血管畸形病例。
一名27岁女性在外部医院出院1周后因进行性加重的头痛、呕吐、乏力及找词困难入院，在外部医院她因疑似创伤性硬膜下血肿接受了保守治疗。计算机断层扫描显示左侧半球亚急性硬膜下血肿增大，为此她接受了钻孔开颅术。术后磁共振成像显示左颞叶后部有一肿块，与海绵状血管畸形相符，且与硬膜下血肿相邻。遂行开颅手术切除病变。她术后恢复过程顺利，恢复良好。
体征和症状、诊断性影像学检查及术中发现提示硬膜下血肿是由海绵状血管畸形的病灶外出血所致，这是与这些血管畸形相关的罕见发现。
临床病程、影像学及术中发现提示硬膜下出血是由海绵状血管畸形的病灶外出血所致。
