Department of Neurosurgery, National Neuroscience Institute, Singapore.
Department of Neurosurgery, National Neuroscience Institute, Singapore.
J Clin Neurosci. 2019 Sep;67:244-248. doi: 10.1016/j.jocn.2019.06.035. Epub 2019 Jul 3.
Chronic subdural haematomas are common neurosurgical conditions, especially in the elderly patients, with straightforward surgical treatments. However, infrequently, tumours are misdiagnosed as subdural haematoma on initial brain CT scans and are only discovered intraoperatively. In this case series, we presented 3 different patients who were initially thought to have subdural haematoma but later found to be tumour mimics of different histological origin. A literature review and discussion of recently published tumour mimics of subdural haematoma was also performed. It is recommended that in patients with suggestive oncological or haematological history, or unusual characteristics on the plain CT brain, a high level of suspicion of tumour mimics needs to be maintained. A full workup with contrast-enhanced magnetic resonance imaging is important to distinguish from subdural haematoma, as the treatment paradigms and prognoses are vastly different.
慢性硬脑膜下血肿是常见的神经外科疾病，尤其在老年患者中较为常见，治疗方法相对简单。然而，在初始脑 CT 扫描中，肿瘤偶尔会被误诊为硬脑膜下血肿，只有在手术中才能发现。在本病例系列中，我们介绍了 3 名不同的患者，他们最初被认为患有硬脑膜下血肿，但后来发现是不同组织学来源的肿瘤模拟物。我们还对最近发表的硬脑膜下血肿肿瘤模拟物进行了文献复习和讨论。建议对于有提示性肿瘤或血液病史的患者，或在普通 CT 脑扫描上有不寻常特征的患者，需要保持对肿瘤模拟物的高度怀疑。完整的检查包括增强磁共振成像对于区分硬脑膜下血肿非常重要，因为治疗方案和预后有很大的不同。
