Organized hematoma developed after suboccipital craniectomy

Area of Science:

• Neuroradiology
• Neurology
• Surgical Pathology

Background:

• Organized hematomas present nonspecific imaging findings on CT and MRI, varying with hemorrhage stages.
• Decompressive suboccipital craniectomy is a procedure for acute cerebellar infarction.
• Post-surgical complications can include hematoma formation.

Observation:

• A 44-year-old male developed an organized hematoma 5 years post-decompressive suboccipital craniectomy.
• Imaging revealed heterogeneous signal intensity on MRI and inhomogeneous hyperdense mass on CT.
• This represents the first reported case of organized hematoma at a suboccipital craniectomy site.

Findings:

• MRI demonstrated heterogeneous signal intensity on T1- and T2-weighted images.
• Precontrast CT showed an inhomogeneous hyperdense mass, potentially with calcification.
• The findings are consistent with variable stages of hemorrhage within the organized hematoma.

Implications:

• Accurate diagnosis of post-surgical organized hematoma is essential.
• Characteristic imaging findings, coupled with surgical history, aid diagnosis.
• Avoiding misdiagnosis prevents unnecessary surgical intervention.