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Rectal dural metastasis masquerading as chronic subdural hematoma: illustrative case

Hantz Filbert C. Siy, Edwin Michael Joy B. Pacia, Allan O. Ong, Maria Ong-Lingan, and Pochollo P. Rosales

patients presenting with subdural hematoma have been even more infrequent, with a 4% incidence in a study among patients with subdural hematoma and active cancer at the Memorial Sloan Kettering Cancer Center. In colorectal carcinoma, regional lymph node involvement is the most common form of spread and usually precedes distant metastasis or the development of carcinomatosis. The most common site of distant metastasis is the liver. Rectal carcinoma spreading to the brain is rare, with an incidence ranging from just 1% to 3%. 2 There have been several reports of

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Development of the Subdural Hematoma in the Elderly (SHE) score to predict mortality

Elizabeth N. Alford, Lauren E. Rotman, Matthew S. Erwood, Robert A. Oster, Matthew C. Davis, H. Bruce C. Pittman, H. Evan Zeiger, and Winfield S. Fisher III

-009-0215-3 2 Balser D , Farooq S , Mehmood T , Reyes M , Samadani U : Actual and projected incidence rates for chronic subdural hematomas in United States Veterans Administration and civilian populations . J Neurosurg 123 : 1209 – 1215 , 2015 10.3171/2014.9.JNS141550 25794342 3 Benedetto N , Gambacciani C , Montemurro N , Morganti R , Perrini P : Surgical management of acute subdural haematomas in elderly: report of a single center experience . Br J Neurosurg 31 : 244 – 248 , 2017 10.1080/02688697.2016.1244249 27760467 4 Brennan PM

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Calcified chronic subdural hematoma: illustrative case

Rupesh Pakrasi, Payoz Pandey, Srijan Das, Shreya Datta, and Dipti Saha

): 330 – 342 . 10.4103/1793-5482.145102 2 Xiao Z , Chen X , Li K , Zhang Z . Calcified chronic subdural hematoma: a case report and literature review . Transl Neurosc Clin . 2017 ; 3 ( 4 ): 220 – 223 . 10.18679/CN11-6030_R.2017.032 12118221 3 Von Rokitansky C . Handbuch der Pathologischen Anatomie . Braumüller & Seidel ; 1846 . 4 Dammers R , ter Laak-Poort MP , Maas AI . Neurological picture. Armoured brain: case report of a symptomatic calcified chronic subdural haematoma . J Neurol Neurosurg Psychiatry

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Spontaneous middle meningeal arteriovenous fistula without cortical venous reflux presenting with acute subdural hematoma: illustrative case

Masahiro Yabuki, Yosuke Akamatsu, Hiroshi Kashimura, Yoshitaka Kubo, and Kuniaki Ogasawara

–14 We demonstrate a rare case of spontaneous acute subdural hematoma (SDH) caused by an MMAVF without CVR and discuss the mechanism of hemorrhagic presentation based on the findings during transarterial Onyx embolization. Illustrative Case A 17-year-old previously healthy male presented to our emergency department with the acute onset of headache. The patient had no history of head trauma. Computed tomography (CT) revealed a left acute SDH without significant mass effect ( Fig. 1A ). T2-weighted magnetic resonance imaging (MRI) performed on admission showed no

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Middle meningeal artery embolization for chronic subdural hematoma in cancer patients with refractory thrombocytopenia

Sungho Lee, Aditya Srivatsan, Visish M. Srinivasan, Stephen R. Chen, Jan-Karl Burkhardt, Jeremiah N. Johnson, Daniel M. S. Raper, Jeffrey S. Weinberg, and Peter Kan

E , Giorgi-Coll S , Whitfield PC , Pathophysiology of chronic subdural haematoma: inflammation, angiogenesis and implications for pharmacotherapy . J Neuroinflammation . 2017 ; 14 ( 1 ): 108 . 10.1186/s12974-017-0881-y 28558815 14 Tanaka T , Kaimori M . Histological study of vascular structure between the dura mater and the outer membrane in chronic subdural hematoma in an adult . Article in Japanese. No Shinkei Geka . 1999 ; 27 ( 5 ): 431 – 436 . 15 Hashimoto T , Ohashi T , Watanabe D , Usefulness of embolization of the middle

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Discovering spontaneous intracranial hypotension after failed middle meningeal artery embolization for subdural hematomas: illustrative cases

Lokeshwar S. Bhenderu, Marcus Wong, and Gavin Britz

. 27693247 7 Takahashi K , Mima T , Akiba Y . Chronic subdural hematoma associated with spontaneous intracranial hypotension: therapeutic strategies and outcomes of 55 cases . Neurol Med Chir (Tokyo) . 2016 ; 56 ( 2 ): 69 – 76 . 26489406 8 Zhang J , Jin D , Pan KH . Epidural blood patch for spontaneous intracranial hypotension with chronic subdural haematoma: a case report and literature review . J Int Med Res . 2016 ; 44 ( 4 ): 976 – 981 . 27225863 9 Okuma Y , Hirotsune N , Sotome Y , Middle meningeal artery

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Posterior fossa subdural hematoma due to ruptured arteriovenous malformation

Case report

Narendra N. Datta, Kwong Y. Chan, John C. K. Kwok, and Christopher Y. F. Poon

Patients with cerebellar arteriovenous malformations (AVM) commonly present to the neurosurgical department after having suffered hemorrhages. The subarachnoid space is the usual location for these often repeating episodes of bleedings. In addition, these patients can present with parenchymal hemorrhage. Acute subdural hematoma caused by a ruptured cerebellar AVM is a rare entity and is not generally recognized. The authors present a case of acute posterior fossa subdural hematoma resulting from a ruptured cerebellar AVM.

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The implications of antithrombotic agents on subdural hematoma evacuation: what does "reversal" truly entail?

Danielle D. Dang, Luke A. Mugge, Purushotham Ramanathan, John V. Dang, Omar K. Awan, Noah Diekemper, Erik J. Teicher, and Mateo Ziu

unclear when considering operative management. 9 , 10 , 15 Its use and safety specifically for subdural hematoma (SDH) evacuation have been insufficiently investigated in comparison with intraparenchymal hemorrhage. 16 Furthermore, reversal incurs its own risk of serious adverse events, including thrombosis, anaphylaxis, and potential delays in care. 9 , 12 , 15 , 17 At our institution, ATT reversal for neurosurgical trauma patients follows multidisciplinary institutional guidelines that direct the use of reversal agents for all patients with active ATT use and

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Cavernous hemangioma of the skull presenting with subdural hematoma

Case report

Oren N. Gottfried, Wayne M. Gluf, and Meic H. Schmidt

Cavernous hemangioma of the calvaria is a very rare disease, and patients usually present with headaches or a visible skull deformity. Few reports of patients presenting with intradiploic or epidural hemorrhages are found in the literature. No case of an intradural hemorrhage from a cavernous hemangioma of the skull has been reported to date. The authors present the case of a 50-year-old man in whom a symptomatic subdural hematoma (SDH) resulting from a cavernous hemangioma of the calvaria had hemorrhaged and eroded through the inner table of the skull and dura mater. The patient underwent surgery for evacuation of the SDH and resection of the calvarial lesion. Postoperatively, the patient experienced immediate relief of his symptoms and had no clinical or radiological recurrence. Calvarial cavernous hemangiomas should be considered in the differential diagnosis of nontraumatic SDHs. Additionally, skull lesions that present with intracranial hemorrhages must be identified and resected at the time of hematoma evacuation to prevent recurrences.

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Subdural hematomas in boxing: the spectrum of consequences

Vincent J. Miele, Julian E. Bailes, Robert C. Cantu, and Craig H. Rabb

✓Boxing is a violent sport in which every participant accepts the risk of brain damage or death. This sport has been linked to acute neurological injury and chronic brain damage. The most common life-threatening injury encountered by its participants is subdural hematoma (SDH), and the most feared consequence of chronic insult to the nervous system is dementia pugilistica, or punch drunkenness. Although advances in imaging and neuropsychological testing have improved our ability to diagnose these injuries, the unprecedented sensitivity and wide availability of these modalities have increased the detection of mild cognitive impairment and small, asymptomatic imaging abnormalities. The question has thus been raised as to where on the spectrum of these injuries an athlete should be permanently banned from the sport.

In this report the authors describe six boxers who were evaluated for SDH sustained during participation in the sport, and who experienced remarkably different outcomes. Their presentations, clinical courses, and boxing careers are detailed. The athletes ranged in age from 24 to 55 years at the time of injury. Two were female and four were male; half of them were amateurs and half were professionals. Treatments ranged from observation only to decompressive craniectomy. Two of the athletes were allowed to participate in the sport after their injury (one following a lengthy legal battle), with no known sequelae. One boxer died within 48 hours of her injury and at least two suffered permanent neurological deficits. In a third, dementia pugilistica was diagnosed 40 years later, and the man died while institutionalized.