• Riccardo Caruso, Alessandro Pesce, and Valentina Martines.
• Neurology and Psychiatry Department, Neurosurgery Division, "Sapienza" University, Roma, Italy.
• World Neurosurg. 2017 Oct 1; 106: 1049.e5-1049.e6.

AbstractThe patient is a 79-year-old male, suffering from advanced metastatic prostate cancer, who developed a progressively worsening ideomotor slowing and was therefore referred to the emergency department of our institution. A plain axial computed tomography (CT) scan revealed a vast hemispheric subdural fluid collection, apparently a subdural hematoma. On closer inspection, and most of all, in hindsight, a tenuously isohyperdense signal irregularity at the frontal aspect of the fluid collection appears. Because of the declined general medical conditions and the paucity of the neurologic impairment, a high-dose, corticosteroid-based conservative strategy was performed. The total body CT scan for the routine oncologic follow-up of the prostate cancer scan fell at 20 days from the first CT of the emergency department. A second contrast-enhanced axial CT scan demonstrated the presence of 2 subdural metastases, presumably the initial pathogenesis of the subdural fluid collection.Copyright © 2017 Elsevier Inc. All rights reserved.

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