J Korean Neurotraumatol Soc.  2008 Jun;4(1):43-47. 10.13004/jknts.2008.4.1.43.

Organized Intracerebral Hematoma after Head Injury

• Park YJ
• Park KH
• Kim TW
• Chi MP
• Kim JO
• Kim JC

• KMID: 1814442
• DOI: http://doi.org/10.13004/jknts.2008.4.1.43

Abstract

We report a case of organized intracerebral hematoma caused by head injury and osteoplastic craniotomy for the hematoma removal. An organizing intracerebral hematoma is relatively rare complication. A 64-year-old male had had a history of explosive head injury and osteoplastic craniotomy and removal of the traumatic intracerebral hematoma. He complained of headache intermittently. Computed tomography (CT) and magnetic resonance (MR) imaging of the brain revealed a heterogeneous round mass in the left frontal lobe and a metallic foreign body with artifact in the parietal lobe. We performed osteoplastic craniotomy and removal of the mass. The lesion was located in the left frontal lobe and removed totally. Histologic examination showed an encapsulated organized hematoma with reactive gliosis. We achieved good results.

Keyword

Head injury; Osteoplastic craniotomy; Organized intracerebral hematoma

MeSH Terms

Artifacts
Brain
Craniocerebral Trauma
Craniotomy
Foreign Bodies
Frontal Lobe
Gliosis
Head
Headache
Hematoma
Humans
Magnetic Resonance Spectroscopy
Male
Parietal Lobe

Figure

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  FIGURE 1 Plain skull X-rays showing an osteoplastic craniotomy in the left frontal region (A) and a metallic foreign body in the vertex (B).

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  FIGURE 2 Computed tomography scans revealing 4×3×2 cm mass (A) showing no contrast-enhancement (B) in the left frontal lobe with a metallic foreign body in the parietal lobe (C).

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  FIGURE 3 Magnetic resonance images revealing 4×3×2 cm mass showing no gadolinium-enhancement in the left frontal lobe and artifact in the parietal lobe. A: Axial T1-weighted MR image. B: T2-weighted MR image. C: Sagittal T1-weighted MR image. D: Gadolinium-enhanced axial T1-weighted MR image. E: Coronal T1-weighted MR image.

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  FIGURE 4 Histopathological examination of the mass lesion exhibiting an organized hematoma that comprised cholesterol cleft (A) (H & E, ×40), blood vessels, infiltration of histiocytes and reactive gliosis around the mass (B) (H & E, ×200).

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  FIGURE 5 Computed tomography scans after operation showing total removal of an organized intracerebral hematoma.

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