Sugawara A, Miura S, Suda Y, Ohmi T, Tanaka T, Tateoka H
Gan No Rinsho. 1986 Feb;32(2):190-5.
A 72 year-old woman was hospitalized with the complaint of headache and nausea. Under the diagnosis of right chronic subdural hematoma, a small craniotomy was performed for the total removal of the hematoma. The patient died 14 days after the operation because of the complication of acute DIC. Histologically, metastasis of adenocarcinoma was detected in the dura mater and skull. Previously reported cases of subdural hematoma secondary to cancer were reviewed in the literature. It is considered that a coagulation defect such as DIC may play a significant role in the development of subdural hematoma. It is suggested that the chronic subdural hematoma in the present case was caused by chronic DIC due to metastasis of bone marrow, and that the patient deteriorated as a result of acute DIC triggered by the surgical therapy.
一名72岁女性因头痛和恶心入院。诊断为右侧慢性硬膜下血肿后，行小骨瓣开颅术以彻底清除血肿。患者术后14天因急性弥散性血管内凝血（DIC）并发症死亡。组织学检查发现硬脑膜和颅骨有腺癌转移。回顾了文献中先前报道的癌症继发硬膜下血肿病例。认为DIC等凝血缺陷可能在硬膜下血肿的发生中起重要作用。提示本例慢性硬膜下血肿是由骨髓转移导致的慢性DIC引起，患者因手术治疗引发急性DIC而病情恶化。
