1/9. meningioma manifesting intracerebral haemorrhage: a possible mechanism of haemorrhage.We present a possible mechanism of intracerebral peritumoural haemorrhage in meningioma based on the clinical data of three of our cases. A meningioma manifesting intracerebral haemorrhage is uncommon and some sporadic case reports have been presented, but without any proven mechanisms. We are presenting three cases of convexity meningioma manifesting spontaneous intracerebral haemorrhage with apoplectiform onset. All three patients had no evidence of bleeding tendency or other predisposing factors for haemorrhage. Preoperative radiological studies showed a solid mass attached to the dura with intracerebral peritumoural haematoma. Total removal of the tumour and haematoma could be achieved in every case. Histological investigation revealed extensive tumour infarction in two cases and fibrosis related to pre-existing ischaemia in the other case. The diagnoses were atypical meningioma in two cases and transitional type in one case. We suggest that extensive tumour infarction might be a cause of spontaneous intracerebral peritumoural haemorrhage in our series of patients.- - - - - - - - - - ranking = 1keywords = haematoma (Clic here for more details about this article) |
2/9. An unusual complication of tapping a ventriculoperitoneal shunt.A case is reported describing a complication of an unsuccessful attempt to aspirate the reservoir of a ventriculoperitoneal shunt system with a suspected shunt infection. This arose due to a misunderstanding of the anatomy of the shunt and resulted in an intracerebral haematoma. The complications of cerebrospinal fluid shunting and the difficulty in the diagnosis thereof are outlined. We discuss the role and method of shunt tapping in diagnosing shunt problems before reviewing the literature describing the rationale. The variation in shunt design is emphasized. Guidelines are then proposed not to dissuade physicians from tapping shunts but to ensure that the procedure is performed safely and in collaboration with neurosurgical units.- - - - - - - - - - ranking = 0.5keywords = haematoma (Clic here for more details about this article) |
3/9. Chronic encapsulated intracerebral haematoma in a patient with medically intractable epilepsy.A patient with a chronic encapsulated intracerebral haematoma presenting with medically intractable epilepsy is described. A tough capsule containing an old haematoma was confirmed surgically, and consisted of dense collagenous tissue with rich neovascularization. The radiological features, aetiology and treatment of this rare occurrence are discussed.- - - - - - - - - - ranking = 3keywords = haematoma (Clic here for more details about this article) |
4/9. Transcranial colour Doppler sonography in emergency management of intracerebral haemorrhage caused by an arteriovenous malformation: case report.We present a case which demonstrates the use of transcranial colour Doppler (TCCD) sonography in screening for an underlying arteriovenous malformation (AVM) in a middle-aged hypertensive patient with a spontaneous thalamic haematoma. The AVM was not detected on emergency CT but its presence, site and shape were demonstrated by TCCD, in the presence of a massive cerebral haemorrhage and acute intracranial hypertension.- - - - - - - - - - ranking = 0.5keywords = haematoma (Clic here for more details about this article) |
5/9. Intracranial meningiomas revealed by non-traumatic subdural haematomas: a series of four cases.OBJECTIVE: A review of the literature shows 33 cases of ipsilateral subdural haematomas (SDH) associated with meningiomas. We suggest that physiopathological mechanisms could be primary haemorrhages from abnormal vessels in the tumours and the opening of the intratumoral haematomas into the subdural space. Our working hypothesis relies on a series of 300 meningiomas operated upon in our department since 1990; of these, 4 were revealed by SDH. CLINICAL PRESENTATION: The four patients surgically treated in our department had developed a progressive impairment of consciousness. There was no history of trauma, blood dyscrasia or anticoagulant therapy. After diagnosis, the SDH was drained, and the meningeal tumour was totally resected once it had been discovered. In one case, the presence of a tumour was demonstrated by magnetic resonance imaging (MRI) performed only after the evacuation of a recurrent SDH. INTERVENTION: In each case, an acute SDH showing signs of recent bleeding was evacuated. The meningeal tumour discovered proved to be the source of the haemorrhage because of the numerous fresh blood clots both around and inside it. histology: In the four cases histology showed fresh intratumoral haemorrhages (ITH), large blood vessels with thin endothelial linings and haemosiderin deposits. In this review, SDH is associated with other haemorrhage sites in 24 of 37 cases (33 our 4 cases). ITH was present in 14 cases (40%). CONCLUSION: The treatment should consist of the extirpation of the meningioma at the same time as the evacuation of the haematoma. If primary ITH from abnormal vessels is the source of SDH, complete meningioma resection should prevent the recurrence of SDH. Subdural membranes and haematomas should therefore be inspected for their intrinsic pathology, especially when there is no history of trauma.- - - - - - - - - - ranking = 4keywords = haematoma (Clic here for more details about this article) |
6/9. Atypical delayed intracranial haematoma following stereotactic biopsy of a right parietal anaplastic oligodendroglioma.The history of a 73-year-old woman with an anaplastic oligodendroglioma is presented, in whom cerebral magnetic resonance imaging (MRI) and brain single-photon emission tomography (SPECT) revealed an intracerebral lesion 17 months before, which was misinterpreted as cerebral infarction. Stereotactic biopsy confirmed the diagnosis, but 4 days after biopsy an unexpected fatal subdural and intraparenchymal bleeding occurred on the biopsy site. Neuroradiological aspects in the differential diagnosis of cerebral lesions as well as the role of small silent postbiopsy haematoma concerning further clinical deterioration are discussed.- - - - - - - - - - ranking = 2.5keywords = haematoma (Clic here for more details about this article) |
7/9. Neurosurgical intervention in a haemophilic child with a subdural and intracerebral haematoma.A case of a 3-year-old boy with severe haemophilia A who had a successful neurosurgical drainage of a combined spontaneous left temporal subdural and intra-parenchimal haematoma is reported. Surgical intervention was required because of clinical worsening during conservative treatment with dexamethasone and factor viii (FVIII) replacement therapy. Continuous FVIII infusion was given before, during and after the procedure. There were no surgical complications and neurological examination remains intact. Neurosurgical interventions may be reserved for special, high-risk cases, as the one presented.- - - - - - - - - - ranking = 2.5keywords = haematoma (Clic here for more details about this article) |
8/9. fatal outcome following foetal cerebellar haemorrhage associated with placental thrombosis.Cerebellar haemorrhage is a rare prenatal event. Possible aetiologies for foetal intracranial haemorrhage include: trauma, asphyxia, infection, vascular defects, blood dyscrasias, ingestion of drugs and alloimmune and isoimmune thrombocytopenia. We report the ultrasonographic diagnosis of a cerebellar haematoma at 21 weeks of gestation. The foetus succumbed at 33 weeks of gestation following rupture of a subcapsular liver haematoma. An autopsy demonstrated a placental foetal thrombotic vasculopathy and thrombi in the chorionic vessels. We assume that hypercoagulability was responsible for the multiple infarcts in the foetus with haemorrhagic transformation in the cerebellum and liver. The differential diagnosis of foetal cerebellar haemorrhage includes maternal hypercoagulability; in this case multiple haemorrhagic/ischaemic events may be encountered during the pregnancy. A thorough investigation to elucidate the aetiology is pertinent in every case of foetal cerebellar haemorrhage in order to enable accurate counselling and correct management.- - - - - - - - - - ranking = 1keywords = haematoma (Clic here for more details about this article) |
9/9. Retropharyngeal haemorrhage from a vertebral artery branch treated with distal flow arrest and particle embolisation.Retropharyngeal haematoma is a rare cause of rapid neck swelling that may result in fatal upper respiratory airway obstruction. Reported causes include trauma, surgery, retropharyngeal inflammation, carotid aneurysm, aberrant artery at the thoracic inlet and bleeding diathesis. We report a 90-year-old man who developed rapid and progressive neck swelling following a minor traumatic episode. Computed tomography showed a large low-density retropharyngeal haematoma extending from the skull base to the mediastinum, with suspected extravasation. The right vertebral artery angiogram confirmed contrast agent extravasation arising from a small branch artery. This was treated with temporary distal flow arrest and particle embolisation.- - - - - - - - - - ranking = 1keywords = haematoma (Clic here for more details about this article) |