Xia Guangwen, Zhang Weitao, Xiao Jing, Shi Lin, Zhang Yiming, Xue Hang
Department of Neurosurgery, Yantaishan Hospital Affiliated to Binzhou Medical University, Yantai, China.
Department of Neurotraumatic Surgery, The First Hospital of Jilin University, Changchun, China.
Front Neurol. 2022 Jul 12;13:911195. doi: 10.3389/fneur.2022.911195. eCollection 2022.
Chronic subdural hematoma, a common neurosurgical disease, is mostly caused by craniocerebral trauma. Chronic subdural hematoma caused by acute myeloblastic leukemia is rarely reported, and its pathogenesis and strategies for clinical treatment remain controversial. Here, we report a rare case of chronic subdural hematoma caused by acute myeloblastic leukemia. The patient's condition deteriorated quickly after admission, and emergency trepanation and drainage of the chronic subdural hematoma was performed, followed by oral administration of atorvastatin. The platelet levels continued to decrease during neurosurgical treatment. Bone marrow cytology, flow cytology, and karyotype analysis suggested acute myelocytic leukemia (AML). Then, the patient was transferred to the hematology department for chemotherapy treatment, during which there was no recurrence of hematoma. Chronic subdural hematoma caused by acute myeloblastic leukemia is a very rare disease. Surgery should be performed when the intracranial hematoma is more than 10 mm thick and the midline structures are displaced by more than 5 mm, and postoperative treatment should be supplemented with atorvastatin to prevent recurrence. Chemotherapy should be given promptly to treat leukemia after stabilization of neurological conditions.
慢性硬膜下血肿是一种常见的神经外科疾病,多由颅脑外伤引起。急性髓系白血病所致慢性硬膜下血肿鲜有报道,其发病机制及临床治疗策略仍存在争议。在此,我们报告一例由急性髓系白血病引起的罕见慢性硬膜下血肿病例。患者入院后病情迅速恶化,遂行慢性硬膜下血肿紧急开颅引流术,术后口服阿托伐他汀。神经外科治疗期间血小板水平持续下降。骨髓细胞学、流式细胞术及核型分析提示急性髓细胞白血病(AML)。随后,患者转至血液科进行化疗,化疗期间血肿未复发。急性髓系白血病所致慢性硬膜下血肿是一种非常罕见的疾病。当颅内血肿厚度超过10mm且中线结构移位超过5mm时应行手术治疗,术后应辅以阿托伐他汀预防复发。神经状况稳定后应立即给予化疗治疗白血病。