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Bilateral chronic subdural haematomas in a patient with meningioma of the superior sagittal sinus – case report and pathophysiological study
- department of neurosurgery
- Acibadem Hospital, Department of Pathology, Istanbul/TURKEY, 34718 Istanbul, Türkiye
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Abstract
Bilateral chronic subdural haemorrhage accompanying meningioma is a very rare clinical condition. We present a case of a 69-year-old female patient with large meningioma completely obliterating the posterior third part of the superior sagittal sinus with accompanying bilateral chronic subdural haematomas. Three anatomical zones of venous collateral circulation were revealed by the preoperative digital subtraction angiography. The tumour and haematomas were removed completely with no major complications.
The most likely pathomechanism of the development of bilateral chronic subdural haematomas was venous hypertension caused by an occlusion of major cerebral venous trunks. As a result of a minor thrombotic incident or insignificant head injury, the distended veins of collateral circulation that were volumetrically burdened could have been damaged. Patients with large tumours occluding the superior sagittal sinus, who did not qualify for or refused surgery, should be carefully monitored clinically and neuroradiologically because of possibly increased risk of an intracranial haemorrhage.
Abstract
Bilateral chronic subdural haemorrhage accompanying meningioma is a very rare clinical condition. We present a case of a 69-year-old female patient with large meningioma completely obliterating the posterior third part of the superior sagittal sinus with accompanying bilateral chronic subdural haematomas. Three anatomical zones of venous collateral circulation were revealed by the preoperative digital subtraction angiography. The tumour and haematomas were removed completely with no major complications.
The most likely pathomechanism of the development of bilateral chronic subdural haematomas was venous hypertension caused by an occlusion of major cerebral venous trunks. As a result of a minor thrombotic incident or insignificant head injury, the distended veins of collateral circulation that were volumetrically burdened could have been damaged. Patients with large tumours occluding the superior sagittal sinus, who did not qualify for or refused surgery, should be carefully monitored clinically and neuroradiologically because of possibly increased risk of an intracranial haemorrhage.
Keywords
superior sagittal sinus meningioma, subdural haematoma, cerebral collateral circulation, sagittal sinus occlusion
Title
Bilateral chronic subdural haematomas in a patient with meningioma of the superior sagittal sinus – case report and pathophysiological study
Journal
Neurologia i Neurochirurgia Polska
Issue
Pages
500-504
Page views
224
Article views/downloads
324
DOI
10.1016/S0028-3843(14)60319-4
Bibliographic record
Neurol Neurochir Pol 2011;45(5):500-504.
Keywords
superior sagittal sinus meningioma
subdural haematoma
cerebral collateral circulation
sagittal sinus occlusion
Authors
Marcin Czyż
Włodzimierz Jarmundowicz
Dariusz Szarek
Paweł Tabakow
Alicja Markowska-Wojciechowska