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酷似慢性硬膜下血肿的恶性脑膜瘤

Malignant Meningioma Mimicking Chronic Subdural Hematoma.

作者信息

Miki Kenji, Kai Yasutoshi, Hiraki Yuka, Kamano Hironori, Oka Kazunari, Natori Yoshihiro

机构信息

Department of Neurosurgery, Aso Iizuka Hospital, Yoshio-machi, Iizuka, Fukuoka, Japan.

Department of Neurosurgery, Aso Iizuka Hospital, Yoshio-machi, Iizuka, Fukuoka, Japan.

出版信息

World Neurosurg. 2019 Apr;124:71-74. doi: 10.1016/j.wneu.2018.12.129. Epub 2019 Jan 4.

Abstract

BACKGROUND

Chronic subdural hematoma (CSDH) is the most common disease encountered in neurosurgery. Diagnoses of CSDH are usually made on the basis of computed tomography (CT) images. In this report, we discuss the case of a patient with meningioma whose findings instead suggested CSDH.

CASE DESCRIPTION

A 91-year-old woman complained of dizziness. Brain CT imaging revealed a low-density subdural space, following which we diagnosed her with CSDH. On the same day, we performed burr hole surgery. However, when opening the burr hole and cutting the dura, a light yellowish tumor was observed under the dura. After the operation, her condition deteriorated and she died 2 days later. After 10 days, pathologic examination of the tumor specimen led to a diagnosis of atypical meningioma.

CONCLUSIONS

In almost all cases, CSDH can be diagnosed using CT images only. However, our patient's true diagnosis was meningioma, rather than CSDH. We rouse attention not to take it for CSDH with a CT image easily.

摘要

背景

慢性硬膜下血肿(CSDH)是神经外科最常见的疾病。CSDH的诊断通常基于计算机断层扫描(CT)图像。在本报告中,我们讨论了一例脑膜瘤患者,其检查结果却提示为CSDH。

病例描述

一名91岁女性主诉头晕。脑部CT成像显示硬膜下间隙低密度,据此我们诊断她患有CSDH。同一天,我们进行了钻孔手术。然而,在打开钻孔并切开硬脑膜时,在硬脑膜下观察到一个浅黄色肿瘤。术后,她的病情恶化,两天后死亡。10天后,肿瘤标本的病理检查诊断为非典型脑膜瘤。

结论

几乎在所有情况下,仅使用CT图像即可诊断CSDH。然而,我们患者的真正诊断是脑膜瘤,而非CSDH。我们提醒注意不要轻易仅凭CT图像就将其误诊为CSDH。

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