No shinkei geka. Neurological surgery
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Review Case Reports
[A case of acute subdural hematoma due to dural metastasis from malignant pleural mesothelioma].
A rare case of acute subdural hematoma due to dural metastasis from malignant pleural mesothelioma is reported. A 65-year-old man was brought to a nearby hospital complaining of lumbago. He suddenly complained of headache on the third hospital day and fell into a deep coma within a short while. ⋯ Histopathology showed that many tumor cell nests were found only within the dilated veins of the dura. There, acute subdural hematoma was assumed to have developed suddenly and there was massive bleeding from the capillaries of the inner vascular layer of the dura. The relevant literature about intracranial metastasis of malignant pleural mesothelioma was reviewed, and the mechanism of subdural hematoma due to dural metastasis from malignant tumor was discussed.
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Two cases of traumatic intracerebral pneumocephalus, a rare complication of head trauma, are presented. Case 1: A 14-year-old boy had a strong concussion in his forehead due to a motorbike accident. Slightly obtunded on admission showing GCS 10, he became conscious in several days. ⋯ These two patients showed a small amount of cerebrospinal fluid (CSF) rhinorrhea before the operation. Following the surgical repair, no recurrence of pneumocephalus and CSF rhinorrhea has been seen in either case. Intracerebral pneumocephalus secondary to closed head trauma was thought to have been due to herniation of contused brain into a craniodural defect.(ABSTRACT TRUNCATED AT 250 WORDS)