Giant Globular (Biconvex) Chronic Subdural Hematoma

Abstract Introduction Hydrocephalus is a frequent neurological condition in childhood. The most common approach to this disease is still ventricular shunting. However, shunting problems, including catheter infection or shunting malfunctioning, contribute to several complications, such a...

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Main Authors: Paulo Roberto Louzada, Juliana Jarruj Beliki
Format: Article
Language:English
Published: Thieme Revinter Publicações Ltda. 2016-08-01
Series:Brazilian Neurosurgery
Subjects:
Online Access:http://www.thieme-connect.de/DOI/DOI?10.1055/s-0036-1585415
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author Paulo Roberto Louzada
Juliana Jarruj Beliki
author_facet Paulo Roberto Louzada
Juliana Jarruj Beliki
author_sort Paulo Roberto Louzada
collection DOAJ
description Abstract Introduction Hydrocephalus is a frequent neurological condition in childhood. The most common approach to this disease is still ventricular shunting. However, shunting problems, including catheter infection or shunting malfunctioning, contribute to several complications, such as extra-axial hematomas, which are a possibly life-threatening. Case report We report the case of a 6-month-old female infant victim of brain trauma. She was previously shunted because of an obstructive hydrocephalus consequent of an aqueductal stenosis diagnosed early after birth. After brain injury, initial symptoms were only irritability and horizontal nystagmus. A computed tomography scan revealed an extra-axial mass lesion that suggested a giant globular extradural hematoma. The patient was submitted to a small exploratory craniectomy to evacuate the blood clot. Surprisingly, the supposed extradural hematoma was, in fact, a chronic subdural hematoma with an unusual shape. After the surgical drainage, the patient remained asymptomatic. No lesion recurrence has been detected so far. Conclusions The case illustrates a very uncommon and interesting presentation of a common neurosurgical disease. A full characterization of the lesion and its pathophysiology is made, and a particular surgical management is proposed and thoroughly discussed.
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spelling doaj.art-3289fbbe74674cd1984fb433b69184222022-12-21T22:46:41ZengThieme Revinter Publicações Ltda.Brazilian Neurosurgery0103-53552359-59222016-08-01350431932210.1055/s-0036-1585415Giant Globular (Biconvex) Chronic Subdural HematomaPaulo Roberto Louzada0Juliana Jarruj Beliki1Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, BrazilNeurosurgery Service, Hospital Municipal Souza Aguiar, Rio de Janeiro, BrazilAbstract Introduction Hydrocephalus is a frequent neurological condition in childhood. The most common approach to this disease is still ventricular shunting. However, shunting problems, including catheter infection or shunting malfunctioning, contribute to several complications, such as extra-axial hematomas, which are a possibly life-threatening. Case report We report the case of a 6-month-old female infant victim of brain trauma. She was previously shunted because of an obstructive hydrocephalus consequent of an aqueductal stenosis diagnosed early after birth. After brain injury, initial symptoms were only irritability and horizontal nystagmus. A computed tomography scan revealed an extra-axial mass lesion that suggested a giant globular extradural hematoma. The patient was submitted to a small exploratory craniectomy to evacuate the blood clot. Surprisingly, the supposed extradural hematoma was, in fact, a chronic subdural hematoma with an unusual shape. After the surgical drainage, the patient remained asymptomatic. No lesion recurrence has been detected so far. Conclusions The case illustrates a very uncommon and interesting presentation of a common neurosurgical disease. A full characterization of the lesion and its pathophysiology is made, and a particular surgical management is proposed and thoroughly discussed.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0036-1585415hydrocephalusventriculoperitoneal shunttraumatic brain injurysubdural hematomaglobular hematoma
spellingShingle Paulo Roberto Louzada
Juliana Jarruj Beliki
Giant Globular (Biconvex) Chronic Subdural Hematoma
Brazilian Neurosurgery
hydrocephalus
ventriculoperitoneal shunt
traumatic brain injury
subdural hematoma
globular hematoma
title Giant Globular (Biconvex) Chronic Subdural Hematoma
title_full Giant Globular (Biconvex) Chronic Subdural Hematoma
title_fullStr Giant Globular (Biconvex) Chronic Subdural Hematoma
title_full_unstemmed Giant Globular (Biconvex) Chronic Subdural Hematoma
title_short Giant Globular (Biconvex) Chronic Subdural Hematoma
title_sort giant globular biconvex chronic subdural hematoma
topic hydrocephalus
ventriculoperitoneal shunt
traumatic brain injury
subdural hematoma
globular hematoma
url http://www.thieme-connect.de/DOI/DOI?10.1055/s-0036-1585415
work_keys_str_mv AT paulorobertolouzada giantglobularbiconvexchronicsubduralhematoma
AT julianajarrujbeliki giantglobularbiconvexchronicsubduralhematoma