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Delayed chronic intracranial subdural hematoma complicating resection of a tanycytic thoracic ependymoma
Rosario Maugeri1, Antonella Giugno1, Francesca Graziano1
1Department of Experimental Biomedicine and Clinical Neuroscience, Neurosurgical Unit, Paolo Giaccone University Hospital, Palermo, Italy.
Background:
To demonstrate that the diagnosis of an intracranial subdural hematoma should be considered for patients presenting with acute or delayed symptoms of intracranial pathology following resection of a spinal tumor.
Case Description:
We present a case of a 57-year-old woman found to have a chronic subdural hematoma 1 month following resection of a thoracic extramedullary ependymoma. Evacuation of the hematoma through a burr hole relieved the presenting symptoms and signs. Resolution of the hematoma was confirmed with a computed tomography (CT) scan.
Conclusion:
Headache and other symptoms not referable to spinal pathology should be regarded as a warning sign of an intracranial subdural hematoma, and a CT scan of the head should be obtained. The mechanism of the development of the hematoma may be related to the leakage of cerebrospinal fluid with subsequent intracranial hypotension leading to an expanding subdural space and hemorrhage.
