title: Acute aggravation of subdural fluid collection associated with dural metastasis of malignant neoplasms: case report and review of the literature.
abstract: A 63-year-old woman was admitted to our hospital with serious headache and vomiting. Five months before admission, she had undergone surgery for a primary advanced gastric cancer. Neuroradiological examinations revealed subdural fluid collection. We twice performed evacuation of the subdural fluid collection. However, aggravation of her state of consciousness progressed and she passed away. Histological examinations demonstrated that the dural veins were infiltrated by numerous tumor cells that produced mucus; however, ruptured vessels were not found. Furthermore, the subdural fluid collection increased shortly after the initial operation. We infer that the cause of the collection, which was associated with the dural metastasis of malignant tumors, was not only mucin secretion by tumor cells but also a rapid increase in perfusion pressure in the vessels of the dura mater, resulting in extravasation of plasma components into the subdural space. Our case demonstrates that the pathogenetic mechanism that is specific for subdural fluid collection caused by dural metastasis of malignant tumors differs from the mechanism of production of subdural hematoma associated with dural metastasis.
authors.affiliation: Division of Neurosurgery, Department of Neurological Surgery, Nihon University School of Medicine, 30-1 Oyaguchi Kami-cho, Itabashi-ku, Tokyo, 173-8610, Japan, kimura.shigeyoshi._@ja3.so-net.ne.jp.
authors.forename: Shigeyoshi
authors.initials: S
authors.lastname: Kimura
authors.forename: Akio
authors.initials: A
authors.lastname: Kotani
authors.forename: Toshiro
authors.initials: T
authors.lastname: Takimoto
authors.forename: Atsuo
authors.initials: A
authors.lastname: Yoshino
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Katayama
mesh_terms: D000208:Acute Disease; D018450:Disease Progression; D004388:Dura Mater; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008577:Meningeal Neoplasms / Q000150:complications / Q000556:secondary*; D008579:Meningioma / Q000150:complications / Q000556:secondary*; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000473:pathology; D013353:Subdural Effusion / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery
references.citation: Clin Neurol Neurosurg. 1992;94(3):235-40
references.pmid: 1327614
references.citation: J Neurosurg. 1970 Jul;33(1):85-7
references.pmid: 5427031
references.citation: J Neurosurg. 1988 Apr;68(4):642-4
references.pmid: 3351593
references.citation: Br J Cancer. 1953 Dec;7(4):438-48
references.pmid: 13126386
references.citation: No Shinkei Geka. 1985 Sep;13(9):999-1004
references.pmid: 4069318
references.citation: N Engl J Med. 1972 Sep 28;287(13):656-63
references.pmid: 5076462
references.citation: Neuroradiology. 1980 Dec;20(4):213-8
references.pmid: 7465041
references.citation: Neurol Med Chir (Tokyo). 2005 Oct;45(10):519-22
references.pmid: 16247237
references.citation: Neurol Med Chir (Tokyo). 1987 Sep;27(9):892-8
references.pmid: 2451180
references.citation: Neurol Med Chir (Tokyo). 1979 Jan;19(1):39-44
references.pmid: 84354
references.citation: Rev Neurol (Paris). 1999 May;155(5):383-5
references.pmid: 10427602
references.citation: Neurosurgery. 1982 Nov;11(5):678-80
references.pmid: 7155333
references.citation: No Shinkei Geka. 1994 Mar;22(3):247-51
references.pmid: 8133966
references.citation: Neurosurgery. 1990 Oct;27(4):619-24; discussion 624-5
references.pmid: 2172860
references.citation: Neurosurgery. 1991 Sep;29(3):464-6
references.pmid: 1922720
references.citation: J Neurosurg. 1983 Mar;58(3):398-401
references.pmid: 6827326
references.citation: Acta Neurochir (Wien). 1980;52(1-2):61-5
references.pmid: 7376947
references.citation: Cancer. 1978 Oct;42(4):2015-8
references.pmid: 361219
references.citation: No Shinkei Geka. 2007 May;35(5):511-3
references.pmid: 17491348
references.citation: J Urol. 1986 Apr;135(4):803-4
references.pmid: 3959210
references.citation: Neurol Med Chir (Tokyo). 1982 Apr;22(4):309-13
references.pmid: 6179003
references.citation: No Shinkei Geka. 1983 Jun;11(6):651-6
references.pmid: 6621789
references.citation: Neurol Med Chir (Tokyo). 1985 Jul;25(7):568-70
references.pmid: 2415852
references.citation: No Shinkei Geka. 1994 Sep;22(9):857-62
references.pmid: 8090269
references.citation: Arch Neurol. 1966 Dec;15(6):649-52
references.pmid: 5926003
references.citation: Cancer. 1973 Dec;32(6):1370-3
references.pmid: 4757928
references.citation: J Neurosurg. 1974 Nov;41(5):610-3
references.pmid: 4425200
references.citation: No Shinkei Geka. 1990 Jun;18(6):539-42
references.pmid: 2395513
references.citation: Neurology. 1986 Mar;36(3):418-20
references.pmid: 3951713
references.citation: No Shinkei Geka. 1989 Aug;17(8):763-8
references.pmid: 2586717