Department of Neurosurgery, Harvard University, Boston, MA, United States
Commentary
Chronic Subdural Hematoma Secondary to Cortical Cerebral Artery Perforation
Author(s): Mazen Nofual*, Conrad Liang, Paulio Yanez and Mark Calayag
Introduction: Chronic Subdural Hematoma (CSDH) is generally attributed to
pathological changes in the arterial system of the dura mater. There are no
case reports of CSDH due to cerebral cortical artery perforation.
Method: We report a case of spontaneous CSDH caused by cortical artery
rupture that was identified on digital subtraction angiography and could be
visualized on Computed Tomographic Angiography (CTA).
Result: A 56-year-old man presented with daily headache for three weeks
with no history of trauma. Neurologic exam only showed subtle left pronator
drift. A CT scan of the head showed a right CSDH with a midline shift. CTA
was suspicious for a dilated vein in the subdural collection. Catheter cerebral
angiogram demonstrated contrast extravasation from a small cortical
branch of the middl.. View More»