case_images: PMC7398374_01
case_images: a MRA showed a poor arterial supply (yellow arrow). The artery closest to the lesion is located outside the lesion (red arrow). b CT suggested an irregular destruction of the occipital bone and small cysts within the lesion. c MRV showed the left transverse sinus was blocked totally (yellow arrow). d The postoperative CT was negative, no obvious sign of bleeding. e Pathological examination found "giant cells" around the cysts (green arrow), which should be hemosiderin-laden macrophages. We can see that these cells are scattered within the lesions (yellow arrow). f There were numerous cystic spaces (blue arrow) containing bloody fluid (red arrow) in the lesion, which is easily mistaken as an ABC
case_images: 41016_2019_155_Fig1_HTML.jpg
case_images: PMC7398374_01_41016_2019_155_Fig1_HTML.jpg
case_images: Fig1
case_images: Magnetic resonance angiography (MRA) did not find obvious arterial supply within the lesion (Fig. 1a). CT suggested an irregular destruction of the occipital bone and small cysts within the lesion (Fig. 1b). Magnetic resonance venography (MRV) showed that the left occipital sinus was blocked totally (Fig. 1c). Postoperative CT was negative (Fig. 1d).
case_images: a After puncturing, a compression caused by epidural hematoma was found on CT (yellow arrow). b Postoperative CT found a hematoma (24 h after surgery). c The mesh was fixed well. d Four days after surgery, hematoma was obviously absorbed. e, f Three months of surgery, the mesh was well fixed, no bleeding and subcutaneous hydrops
case_images: 41016_2019_155_Fig2_HTML.jpg
case_images: PMC7398374_01_41016_2019_155_Fig2_HTML.jpg
case_images: Fig2
case_images: A compression and sign of cerebral hernia caused by epidural hematoma was found on CT (Fig. 2a). APTT was still abnormal but no signs of bleeding were found. A hematoma was still visible on CT but showed no signs of enlargement (Fig. 2b). The mesh was fixed well (Fig. 2c). FFP. Four days after surgery, hematoma was significant absorbed (Fig. 2d) and the APTT was improved (32.7 s). Three months after discharging, a radiological follow-up showed the titanium mesh healed well with surrounding tissue without subcutaneous hydrops (Fig. 2e, f).