Cerebral venous sinus thrombosis associated with systemic multiple hemangiomas manifesting as chronic subdural hematoma--case report.
A 35-year-old male was admitted with headache, nausea, and vomiting persisting for 2 days. Computed tomography (CT) revealed a left chronic subdural hematoma. Cerebral angiography demonstrated cerebral venous sinus thrombosis (CVST). He had presented with a subcutaneous mass involving the neck at age 2 years, which was shown to be a cavernous angioma, and thereafter shown signs of consumptive coagulopathy with systemic multiple hemangiomas. Burr hole aspiration of the hematoma was performed. Seventy-two-hours later, he developed clouding of consciousness and right hemiparesis. CT revealed a fresh hematoma in the operated subdural cavity and hemorrhagic diathesis manifested. A frontotemporoparietal large craniotomy was performed to remove the hematoma. Extensive electrocauterization was required. He had a satisfactory postoperative course. Collateral venous pathways, resulting from the CVST due to systemic multiple hemangiomas, may have caused hemodynamic stress in the bridging veins which subsequently induced chronic subdural hematoma.
Department of Neurosurgery, Kushiro City General Hospital, Hokkaido.
Y
Y
Takamura
S
S
Morimoto
T
T
Uede
T
T
Yamaki
Y
Y
Minamida
A
A
Yamamura
T
T
Nakagawa
D000328:Adult; D000798:Angiomatosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D002533:Cerebral Angiography; D002561:Cerebrovascular Disorders / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D002908:Chronic Disease; D004211:Disseminated Intravascular Coagulation / Q000150:complications / Q000503:physiopathology; D004322:Drainage; D006258:Head and Neck Neoplasms; D006392:Hemangioma, Cavernous; D006408:Hematoma, Subdural / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D006474:Hemorrhagic Disorders / Q000209:etiology; D006801:Humans; D008297:Male; D009378:Neoplasms, Multiple Primary; D009389:Neovascularization, Pathologic / Q000209:etiology; D012851:Sinus Thrombosis, Intracranial / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D014057:Tomography, X-Ray Computed; D014207:Trephining