[A case of epidural hematoma due to dural metastasis]

A case of epidural hematoma due to dural metastasis is reported. A 62-year-old man was admitted to our hospital with generalized convulsion. A month prior, he underwent a tumor-removal operation for dural metastasis of lung cancer. CT scan on admission showed an epidural hematoma at the left frontal region. At operation, the epidural hematoma and dural invasion of neoplasm was found and removed. Pathological examination revealed dural metastasis of the poorly differentiated adenocarcinoma. According to the literature, intracranial metastasis of a bronchogenic carcinoma bleeds more often than that of other carcinomas. The particular vascular invasiveness of the neoplasm or a hemorrhagic diathesis is considered as the cause of the hemorrhage. In the present case the pathogenesis of the hemorrhage was thought to be the hypervascularity of the rapid growth tumor, fragility of the tumor vessels, and invasiveness of the tumor into the dural vessels. Adding to these, two other factors could play an important role in forming epidural hematoma; 1) the tumor existed mainly in the epidural surface and 2) dural adhesion of the cranial bone was not so tight.