case_images: PMC10954357_01
case_images: Nonenhanced axial CT scan demonstrates large right temporoparietal fluid collection (a). Nonenhanced axial postop CT scan demonstrates failure of surgical drainage due to the presence of dural layer in deep portion of the collection (b). Follow-up nonenhanced axial CT scan showed interval hemorrhage (blue arrow) in the collection (c).
case_images: CRIM2024-5561686.001.jpg
case_images: PMC10954357_01_CRIM2024-5561686.001.jpg
case_images: fig1
case_images: A head computed tomography scan (CT scan) was quickly requested for the patient, in which a large fluid collection over the right temporoparietal region with mass effect was observed, and the neurosurgeon drained it with the initial diagnosis of subdural hematoma (Figure 1(a)). However, the postoperative CT scan demonstrated the failure of surgical drainage due to the presence of a dural layer in the deep portion of the collection (Figure 1(b)). After 3 days, a follow-up CT scan showed an interval hemorrhage in the collection (Figure 1(c)).
case_images: Sagittal T2W (a) and coronal T2W images demonstrated right pariental complex fluid collection with internal septation (blue arrow) and different internal hemorrhagic stages and mass effect (b). Axial FLAIR image demonstrated that collection over right temporoparietal extraaxial collection with mass effect has focal internal layering (c). Contrast-enhanced T1W image showed diffuse nodular dural thickening and dural enhancement (orange arrow) (d).
case_images: CRIM2024-5561686.002.jpg
case_images: PMC10954357_01_CRIM2024-5561686.002.jpg
case_images: fig2
case_images: MRI identified diffuse nodular dural thickening with internal septations and different internal hemorrhagic stages (hypertrophic pachymeningitis) on the right side (Figures 2(a)-2(d)) with no evidence of brain parenchymal involvement.