Kushmakov Robert, Cazorla-Morales Ilona, Brenner Keith, Araten David, Shapiro Maksim, Raz Eytan, Placantonakis Dimitris G
Touro College of Osteopathic Medicine, New York, New York.
Departments ofNeurosurgery and.
J Neurosurg Case Lessons. 2024 Nov 4;8(19). doi: 10.3171/CASE24483.
Subdural hematoma is a rare manifestation of hereditary hemorrhagic telangiectasia (HHT), also known as Osler-Weber-Rendu disease. Here, the authors present a patient with HHT and a large chronic subdural hematoma, for whom nonsurgical management was pursued.
A 49-year-old right-handed male with a history of hypertension and familial HHT presented with complaints of mild confusion and left hemiparesis over several days. Noncontrast head computed tomography images demonstrated a large chronic right hemisphere subdural hematoma compressing the right cerebral hemisphere and causing a 1.3-cm midline shift. Due to concerns about surgical complications arising from hemorrhages of cryptic telangiectasias, the patient was treated conservatively with middle meningeal artery embolization and adjuvant tranexamic acid. There was clinical and radiological resolution several months later.
This case highlights the rarity of a subdural hematoma as a manifestation of HHT and the nonsurgical treatment strategy as a mechanism to avoid hemorrhagic complications of surgical evacuation. https://thejns.org/doi/10.3171/CASE24483.
硬膜下血肿是遗传性出血性毛细血管扩张症（HHT）的一种罕见表现，HHT也被称为奥斯勒-韦伯-伦杜病。在此，作者报告一名患有HHT和巨大慢性硬膜下血肿的患者，对其采用了非手术治疗。
一名49岁右利手男性，有高血压病史和家族性HHT，数天来出现轻度意识模糊和左侧偏瘫的症状。头颅非增强计算机断层扫描图像显示，一个巨大的慢性右侧半球硬膜下血肿压迫右侧大脑半球，导致中线移位1.3厘米。由于担心隐匿性毛细血管扩张出血引发手术并发症，对该患者采用脑膜中动脉栓塞和辅助氨甲环酸进行保守治疗。数月后患者临床症状和影像学表现均得到缓解。
该病例凸显了硬膜下血肿作为HHT表现的罕见性，以及非手术治疗策略作为避免手术清除血肿出血并发症的一种手段。https://thejns.org/doi/10.3171/CASE24483 。
