Visualization of an actively bleeding cortical vessel into the subdural space by CT angiography.
Spontaneous subdural hematomas of arterial origin are rare with only a few published case reports in the literature. In the CT era, vessel imaging of extra-axial hematomas is not commonly performed. In this case report we present a patient with a large, spontaneous acute subdural hematoma that demonstrated active contrast extravasation from a small cortical vessel on CT angiography. During surgical evacuation the vessel was confirmed to be a small cortical artery that was bulging through the arachnoid membrane and bleeding into the subdural space. The historical, radiographic, and clinical aspects of this unusual cause of subdural hematoma are discussed.
Dalfino
John C
JC
Department of Surgery, Division of Neurosurgery, Albany Medical Center, 47 New Scotland Ave, MC 10, Albany, NY, USA. john.dalfino@gmail.com
Boulos
Alan S
AS
D002533:Cerebral Angiography; D003287:Contrast Media; D019299:Decompression, Surgical; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000000981:diagnostic imaging*; D005260:Female; D020199:Hematoma, Subdural, Acute / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D006801:Humans; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D003287:Contrast Media