No shinkei geka. Neurological surgery · 2010
[A case of acute subdural hematoma from dissection of cortico-dural anastomosis].
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Satow Takeshi, Yamada Shigeki, Terashima Tsuyoshi, Takeuchi Eiji, Yagi Miyuki, Saiki Masaaki
Аннотация
A case of acute subdural hematoma caused by rupture of a bridging artery between the dura and the cortical surface is reported. A 49-year-old man complained of headache in the left temporal area after he had lifted up a heavy load. His symptom did not improve in spite of taking analgesics, so he was transferred to our hospital. Brain CT disclosed left acute subdural hematoma. Soon after admission, he became comatose and developed right hemiplegia. The cerebral angiogram displayed a tapering occlusion of a branch of the left middle cerebral artery. Emergent decompressive craniectomy was performed, and the anastomotic artery between the dura mater and the cortical artery was followed until it appeared normal in the cortical sulcus. Proximal occlusion of the artery was carried out. Pathological examination demonstrated the dissection of the anastomotic artery. This is the first reported and pathologically-proven case of acute subdural hematoma caused by dissection of the anastomotic artery between the dura mater and the cortical artery.