Chronic expanding intracerebral hematoma

Area of Science:

• Neurology
• Neurosurgery
• Radiology

Background:

• Chronic intracerebral hematomas are rare in normotensive individuals.
• These lesions can mimic brain malignancies on imaging.
• Understanding their characteristics is crucial for diagnosis and treatment.

Purpose of the Study:

• To report on the clinical presentation, imaging findings, and surgical management of chronic intracerebral hematomas.
• To highlight the differential diagnosis of ring-shaped brain lesions.
• To discuss treatment strategies for this condition.

Main Methods:

• Retrospective case series of 10 normotensive patients.
• Review of clinical data, including symptoms and duration.
• Analysis of neuroimaging findings (Computerized Tomography, Arteriography).
• Evaluation of surgical pathology and outcomes.

Main Results:

• Median age at diagnosis was 42 years, with a median symptom duration of 22 days.
• Seizures occurred in 50% of cases; imaging showed ring-shaped lesions with mass effect and edema.
• Most lesions were avascular, with superficial white matter involvement; surgical specimens revealed encapsulated hematomas with organized blood.
• Occult cerebrovascular malformations were found in two patients.
• Two deaths occurred due to recurrent postoperative hemorrhage.

Conclusions:

• Chronic intracerebral hematomas can mimic brain tumors and should be considered in the differential diagnosis of ring-shaped lesions.
• Surgical intervention is a primary treatment modality.
• Careful surgical planning and management are necessary to minimize risks such as postoperative hemorrhage.