CASE REPORT
O trauma craniano, provocando lesão na artéria meníngea média, veia meníngea média ou seios venosos durais, é responsável pela maioria dos casos de hematoma epidural (HED). O HED espontâneo é uma entidade rara na prática clínica. Causas comuns incluem sinusite, anormalidades de coagulação, metástase dural e histiocitose de células de Langerhans. O hematoma epidural espontâneo não traumático é uma complicação rara e, muitas vezes, não mencionada da doença falciforme (DF). É frequentemente associado ao infarto ósseo do crânio. Relatamos um caso de HED espontâneo em paciente com DF e revisamos a literatura mundial sobre essa entidade rara. Um homem de 18 anos com anemia falciforme apresentou crise vaso-oclusiva. Cerca de 24 horas após sua internação, o paciente apresentou súbita deterioração do estado mental. Uma tomografia computadorizada (TC) da cabeça de emergência revelou um grande hematoma peridural parietal do lado direito com efeito de massa e desvio da linha média. O paciente foi submetido à evacuação de hematoma emergente e teve boa recuperação. As possíveis patogêneses desta condição rara são discutidas.
Trauma to the skull causing injury to the middle meningeal artery, middle meningeal vein, or dural venous sinuses is responsible for most cases of epidural Haematoma (EDH). Spontaneous EDH is a rare entity in clinical practice. Common causes include sinusitis, coagulation abnormalities, dural metastasis, and Langerhans cell histiocytosis. Non traumatic spontaneous epidural Haematoma is a rare and often unmentioned complication of sickle cell disease (SCD). It is often associated with skull bone infarction. We report a case of spontaneous EDH in a patient with SCD and review the world literature regarding this rare entity. An 18-year-old male with sickle cell disease presented with vaso-occlusive crisis. About 24 hours after hospital admission, the patient had sudden deterioration of his mental status. An emergency CT scan of the head revealed a large right-sided parietal epidural hematoma with mass effect and midline shift. The patient underwent emergent hematoma evacuation, and he made good recovery. The possible pathogenesis of this rare condition are discussed.
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1 MD, Department of Neurosurgery, PDU Medical College and Civil Hospital, Rajkot, Gujarat, India.
Received Feb 1, 2023
Accepted Feb 20, 2023
