Teramoto Shinichiro, Tsunoda Akira, Kawamura Kaito, Sugiyama Natsuki, Saito Rikizo, Maruki Chikashi
Department of Neurosurgery, Koshigaya Municipal Hospital, Saitama, Japan.
Surg J (N Y). 2018 Jun 11;4(2):e91-e95. doi: 10.1055/s-0038-1660511. eCollection 2018 Apr.
A 70-year-old man, who had previously undergone surgical resection of left parasagittal meningioma involving the middle third of the superior sagittal sinus (SSS) two times, presented with recurrence of the tumor. We performed removal of the tumor combined with SSS resection as Simpson grade II. After tumor removal, since a left dominant bilateral chronic subdural hematoma (CSDH) appeared, it was treated by burr hole surgery. However, because the CSDH rapidly and repeatedly recurred and eventually changed to acute subdural hematoma, elimination of the hematoma with craniotomy was accomplished. The patient unfortunately died of worsening of general condition despite aggressive treatment. Histopathology of brain autopsy showed invasion of anaplastic meningioma cells spreading to the whole outer membrane of the subdural hematoma. Subdural hematoma is less commonly associated with meningioma. Our case indicates the possibility that subdural hematoma associated with meningioma is formed by a different mechanism from those reported previously.
一名70岁男性，此前曾两次接受手术切除累及上矢状窦（SSS）中三分之一的左矢状窦旁脑膜瘤，现出现肿瘤复发。我们进行了肿瘤切除并联合SSS切除，手术达到辛普森二级。肿瘤切除后，由于出现左侧优势的双侧慢性硬膜下血肿（CSDH），遂通过钻孔手术进行治疗。然而，由于CSDH迅速反复复发并最终转变为急性硬膜下血肿，于是通过开颅手术清除了血肿。尽管进行了积极治疗，但患者不幸因全身状况恶化而死亡。脑尸检的组织病理学显示，间变性脑膜瘤细胞浸润扩散至硬膜下血肿的整个外膜。硬膜下血肿与脑膜瘤的关联较少见。我们的病例表明，与脑膜瘤相关的硬膜下血肿可能是由与先前报道不同的机制形成的。
