A Case of Dysfibrinogenemia with Intractable Chronic Subdural Hematoma

Abstract

  We report a case of bilateral chronic subdural hematomas (CSDHs) that recurred three times in a patient with a history of gastric cancer and dysfibrinogenemia. We resorted to embolization of the middle meningeal arteries (MMA) to prevent recurrence. Angiograms showed abnormal shadows that suggested exudative bleeding from small branches of the MMA. While the right CSDH was treated with n-butyl cyanoacrylate (NBCA), the left CSDH was treated with coil embolization. The right side resolved without recurrence ; however, the left side had asymptomatic recurrence. The patient died of disseminated intravascular coagulation (DIC) due to gastric cancer without recurrence of the CSDHs after embolization.
  Embolization of the MMA, especially using NBCA, is an effective treatment for intractable CSDHs under DIC.