Vol 45, No 5 (2011)

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Bilateral chronic subdural haematomas in a patient with meningioma of the superior sagittal sinus – case report and pathophysiological study

Marcin Czyż1, Włodzimierz Jarmundowicz1, Dariusz Szarek1, Paweł Tabakow1, Alicja Markowska-Wojciechowska2
DOI: 10.1016/S0028-3843(14)60319-4
Neurol Neurochir Pol 2011;45(5):500-504.


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.

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Neurologia i Neurochirurgia Polska