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Epidural hematoma secondary to solitary skull metastasis from an ovarian carcinoma.

Kumar PM, Manisha M - Asian J Neurosurg (2014)

Bottom Line: We report a rare case of an acute epidural hematoma (EDH) due to solitary skull metastasis in a 60-year-old patient treated earlier for ovarian carcinoma.The patient presented with head injury followed by unconsciousness and computerized tomography showed a large EDH in the right parietal region along with a contusion of left temporal-parietal lobe and subarachnoid hemorrhage in left sylvian fissure.Emergency craniotomy and evacuation of the EDH was performed and the hemorrhage was determined to be secondary to skull metastasis of ovarian carcinoma; the patient recovered and received whole brain radiation therapy.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, GSL Medical College, Rajahmundry, Andhra Pradesh, India.

ABSTRACT
We report a rare case of an acute epidural hematoma (EDH) due to solitary skull metastasis in a 60-year-old patient treated earlier for ovarian carcinoma. The patient presented with head injury followed by unconsciousness and computerized tomography showed a large EDH in the right parietal region along with a contusion of left temporal-parietal lobe and subarachnoid hemorrhage in left sylvian fissure. Emergency craniotomy and evacuation of the EDH was performed and the hemorrhage was determined to be secondary to skull metastasis of ovarian carcinoma; the patient recovered and received whole brain radiation therapy.

No MeSH data available.


Related in: MedlinePlus

Non-contrast computerized tomography of the brain showing epidural hematoma in the right parietal region, a contusion of left temporal-parietal lobe and subarachnoid hemorrhage in left sylvian fissure
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Figure 1: Non-contrast computerized tomography of the brain showing epidural hematoma in the right parietal region, a contusion of left temporal-parietal lobe and subarachnoid hemorrhage in left sylvian fissure

Mentions: A 60-year-old housewife was brought to our emergency department following a fall from a two wheeler. On admission, she was found to be unconscious with a Glassgow Coma Score of 10/15 (E2 V3 M5), irritable, and without any motor deficits. Past history revealed a curative salpingo-opherectomy performed 3 years ago for ovarian carcinoma. Routine blood investigations were within normal limits. Computerized tomography of brain revealed a 4 × 3 cm epidural hematoma (EDH) in the right parietal region with a lytic lesion of parietal bone of skull overlying the EDH, a contusion of left temporal-parietal lobe and subarachnoid hemorrhage in left sylvian fissure [Figures 1 and 2]. The patient was immediately taken up for surgery. During the operation, no scalp mass or skull fracture was found; rather the parietal bone overlying the EDH was thinned out and was replaced by thick, firm, fibrous, yellowish-brown, hypervascular mass suggestive of tumor tissue. No gross invasion or thickening of the dura was observed. No active bleeding was seen from the dura or its overlying vessels. Hence, it was assumed that the bleeding focus was the destroyed diploic space of the parietal bone and the tumor mass itself. The hematoma, tumor tissue, and a ring of normal looking parietal bone around the lesion were completely removed [Figure 3].


Epidural hematoma secondary to solitary skull metastasis from an ovarian carcinoma.

Kumar PM, Manisha M - Asian J Neurosurg (2014)

Non-contrast computerized tomography of the brain showing epidural hematoma in the right parietal region, a contusion of left temporal-parietal lobe and subarachnoid hemorrhage in left sylvian fissure
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4129576&req=5

Figure 1: Non-contrast computerized tomography of the brain showing epidural hematoma in the right parietal region, a contusion of left temporal-parietal lobe and subarachnoid hemorrhage in left sylvian fissure
Mentions: A 60-year-old housewife was brought to our emergency department following a fall from a two wheeler. On admission, she was found to be unconscious with a Glassgow Coma Score of 10/15 (E2 V3 M5), irritable, and without any motor deficits. Past history revealed a curative salpingo-opherectomy performed 3 years ago for ovarian carcinoma. Routine blood investigations were within normal limits. Computerized tomography of brain revealed a 4 × 3 cm epidural hematoma (EDH) in the right parietal region with a lytic lesion of parietal bone of skull overlying the EDH, a contusion of left temporal-parietal lobe and subarachnoid hemorrhage in left sylvian fissure [Figures 1 and 2]. The patient was immediately taken up for surgery. During the operation, no scalp mass or skull fracture was found; rather the parietal bone overlying the EDH was thinned out and was replaced by thick, firm, fibrous, yellowish-brown, hypervascular mass suggestive of tumor tissue. No gross invasion or thickening of the dura was observed. No active bleeding was seen from the dura or its overlying vessels. Hence, it was assumed that the bleeding focus was the destroyed diploic space of the parietal bone and the tumor mass itself. The hematoma, tumor tissue, and a ring of normal looking parietal bone around the lesion were completely removed [Figure 3].

Bottom Line: We report a rare case of an acute epidural hematoma (EDH) due to solitary skull metastasis in a 60-year-old patient treated earlier for ovarian carcinoma.The patient presented with head injury followed by unconsciousness and computerized tomography showed a large EDH in the right parietal region along with a contusion of left temporal-parietal lobe and subarachnoid hemorrhage in left sylvian fissure.Emergency craniotomy and evacuation of the EDH was performed and the hemorrhage was determined to be secondary to skull metastasis of ovarian carcinoma; the patient recovered and received whole brain radiation therapy.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, GSL Medical College, Rajahmundry, Andhra Pradesh, India.

ABSTRACT
We report a rare case of an acute epidural hematoma (EDH) due to solitary skull metastasis in a 60-year-old patient treated earlier for ovarian carcinoma. The patient presented with head injury followed by unconsciousness and computerized tomography showed a large EDH in the right parietal region along with a contusion of left temporal-parietal lobe and subarachnoid hemorrhage in left sylvian fissure. Emergency craniotomy and evacuation of the EDH was performed and the hemorrhage was determined to be secondary to skull metastasis of ovarian carcinoma; the patient recovered and received whole brain radiation therapy.

No MeSH data available.


Related in: MedlinePlus