TITLE:
Pseudotumoral Chronic Subdural Hematomas on Two Cases
AUTHORS:
Essossinam Kpélao, Kadanga Anthony Békéti, Komi Egu, Komlan Messan Hobli Ahanogbe, Abd El Kader Moumouni, Agbeko Komlan Doléagbenou, Essolim Hodabalo Bakondé, Abdoul Kérim Ouiminga
KEYWORDS:
Calcified Subdural Hematomas, Pseudo, Tumor Symptomatology, Overdrainage
JOURNAL NAME:
Open Journal of Modern Neurosurgery,
Vol.8 No.1,
January
17,
2018
ABSTRACT: Introduction: Calcified forms with
pseudo-tumor symptomatology of chronic subdural hematomas are rare. They are the result of slow bleeding over several
years. The main etiology is related to the complications of the ventriculo-peritoneal
shunt (VP). The purpose of this study was to recall the
peculiarities and physiopathology of its
pseudotumoral hematomas through 2 observations. Observation: Case 1: 8-year-old patient with a history of ventriculoperitoneal shunt at 3
months of age for congenital hydrocephalus, was admitted for functional
impotence of the left-side of the body of insidious onset spreading over 9
months in a chronic headache, blurred vision and generalized seizure. CT scan
showed a heterogeneous subdural hematoma of the right frontoparietal with calcifications. The patient
underwent an excision by morcellation of a yellowish, friable partly calcific
mass. The postoperative history was marked by a total recovery of the
neurological deficit. There was no recurrence at 6 months postoperatively. Case
2: 11-year-old adolescent, treated with VP
shunt at 6 months of age for post-meningitic hydrocephalus, was admitted for
helmet headache, dizziness, lightheadedness and apathy progressing for 3
years. CT scan showed hypodensity of right peri-hemisphere with calcified
linings, exerting a mass effect on the medial structures. The patient was given
a block excision of a calcific mass with blood content. The evolution was marked by the complete resolution of seizures and
hemiparesis. There was no recurrence
at 6 months postoperatively. Conclusion: Calcified subdural hematomas are rare and consecutive to the complications of
VPS. The clinical signs are those of a benign brain tumor. Treatment is
dominated by the difficulties of cerebral reexpression.