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Huge chronic subdural hematoma mimicking cerebral infarction on computed tomography--case report
Satoru Shimizu1, Tatsuya Ozawa, Katsumi Irikura
1Department of Neurosurgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.
Neurologia Medico-Chirurgica
|October 10, 2002
Summary
A 70-year-old experienced altered consciousness due to a misdiagnosed chronic subdural hematoma (CSDH). Preexisting neurological conditions may have contributed to the unexpected expansion of this CSDH.
Area of Science:
- Neurology
- Neurosurgery
- Radiology
Background:
- A 70-year-old male with a history of left cerebral hemisphere cerebrovascular accident presented with progressive consciousness disturbance.
- Initial computed tomography (CT) suggested an extensive, newly developed left cerebral hemispheric infarction.
Observation:
- Magnetic resonance imaging (MRI) revealed findings inconsistent with acute infarction.
- Surgical exploration confirmed the presence of a chronic subdural hematoma (CSDH).
Findings:
- The patient's presentation was ultimately attributed to an unexpectedly expanded CSDH, not acute infarction.
- The underlying neurological condition might have predisposed the patient to CSDH development or expansion.
Implications:
- Highlights the importance of advanced imaging modalities like MRI in differentiating acute stroke from CSDH.
- Underscores the potential role of pre-existing neurological deficits in the pathogenesis of CSDH.
- Emphasizes the need for careful clinical correlation and consideration of alternative diagnoses in patients with complex neurological presentations.