[Brain glioma complicated by subdural hematoma]

Area of Science:

• Neurology
• Neurosurgery
• Oncology

Background:

• Chronic subdural hematoma (CSH) is a significant clinical entity often requiring neurosurgical intervention.
• Gliomas, particularly those in the temporal lobe, can present with diverse and sometimes atypical neurological symptoms.
• The association between intracranial tumors and subdural hematomas is uncommon, necessitating careful diagnostic consideration.

Observation:

• A patient presented with stroke-like symptoms preceding surgical intervention by one month.
• Imaging revealed an encapsulated liquid subdural hematoma.
• Necrosis of the cerebral cortex overlying a left temporal lobe glioma was noted, with a highly vascularized and easily bleeding tumor periphery.

Findings:

• The clinical presentation, imaging findings, and intraoperative observations suggested a primary hemorrhagic event originating from the glioma.
• Hemorrhage likely occurred in the peripheral, necrotic portions of the tumor.
• The hematoma subsequently dissected into the subdural space, leading to the chronic subdural hematoma.

Implications:

• This case highlights an unusual complication of glioma, where tumor hemorrhage can manifest as a chronic subdural hematoma.
• It underscores the importance of considering intraparenchymal tumors as a potential source of subdural bleeding, especially in atypical presentations.
• Accurate diagnosis and timely surgical management are crucial for favorable outcomes in such complex neurosurgical cases.