Prostate dural metastasis presenting as chronic subdural hematoma. A case report and review of the literature

Surgical Neurology International
Alexandros BoukasNicholas Ross

Abstract

Malignant disease metastasising to the cranial dura is rare. Dural metastases manifesting as a subdural fluid collection and presenting as a chronic subdural hematoma is an uncommon entity with unknown pathophysiology. We present a patient with known prostate cancer metastasising to the cranial dura masquerading as a chronic subdural hematoma. The patient presented with bilateral subdural collections manifesting with confusion and dysphasia. Initial drainage of the larger, symptomatic left side improved only temporarily patient's symptoms. A second drainage of the collection was performed on the same side 5 days later and dural biopsies taken during the same procedure revealed prostate metastases. The patient improved slowly and was discharged to a hospice for palliative care management. Prostate dural metastases should be suspected in patients with known prostate cancer presenting with a subdural collection in the absence of cranial trauma. If decision to drain the subdural collection is taken, then biopsies can be taken the same time as they can pose a diagnostic challenge.

References

Nov 1, 1974·Journal of Neurosurgery·R W LeechG A Ojemann
Jul 23, 2003·Cancer·Ivo W Tremont-LukatsVinay K Puduvalli
Apr 25, 2012·Emergency Radiology·Wong-Li YuTom C Y Cheung
Jun 19, 2012·Neurosurgery·Jordan ReichmanLisa M Deangelis
Jul 4, 2012·Surgical Neurology International·Kuriakose J GeorgeMichael G Fehlings

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Citations

Jun 9, 2016·World Neurosurgery·Dragos CatanaEdward Kachur
Nov 10, 2017·Surgical Neurology International·Neil HaranhalliDavid J Altschul
Oct 5, 2018·Asian Journal of Neurosurgery·Abid HoussemChibbaro Salvatore

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