Chronic Encapsulated Expanding Thalamic Hematoma Associated with Obstructive Hydrocephalus following Radiosurgery for a Cerebral Arteriovenous Malformation: A Case Report and Literature Review

Chronic encapsulated intracerebral hematoma is a unique type of intracerebral hematoma accompanied by a capsule that is abundant in fragile microvasculature occasionally causing delayed regrowth. A 37-year-old man who had undergone radiosurgery for an arteriovenous malformation (AVM) causing intrace...

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Main Authors: Jun Takei, Toshihide Tanaka, Yohei Yamamoto, Akihiko Teshigawara, Satoru Tochigi, Yuzuru Hasegawa, Yuichi Murayama
Format: Article
Language:English
Published: Wiley 2016-01-01
Series:Case Reports in Neurological Medicine
Online Access:http://dx.doi.org/10.1155/2016/5130820
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author Jun Takei
Toshihide Tanaka
Yohei Yamamoto
Akihiko Teshigawara
Satoru Tochigi
Yuzuru Hasegawa
Yuichi Murayama
author_facet Jun Takei
Toshihide Tanaka
Yohei Yamamoto
Akihiko Teshigawara
Satoru Tochigi
Yuzuru Hasegawa
Yuichi Murayama
author_sort Jun Takei
collection DOAJ
description Chronic encapsulated intracerebral hematoma is a unique type of intracerebral hematoma accompanied by a capsule that is abundant in fragile microvasculature occasionally causing delayed regrowth. A 37-year-old man who had undergone radiosurgery for an arteriovenous malformation (AVM) causing intracerebral hematoma in the left parietal lobe presented with headache, vomiting, and progressive truncal ataxia due to a cystic lesion that had been noted in the left thalamus, leading to progressive obstructive hydrocephalus. He underwent left frontal craniotomy via a transsylvian fissure approach, and the serous hematoma was aspirated. The hematoma capsule was easy to drain and was partially removed. Pathological findings demonstrated angiomatous fibroblastic granulation tissue with extensive macrophage invasion. The concentration of vascular endothelial growth factor (VEGF) was high in the hematoma (12012 pg/mL). The etiology and pathogenesis of encapsulated hematoma are unclear, but the gross appearance and pathological findings are similar to those of chronic subdural hematoma. Based on the high concentration of VEGF in the hematoma, expansion of the encapsulated hematoma might have been caused by the promotion of vascular permeability of newly formed microvasculature in the capsule.
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spelling doaj-art-59d7b90ba8eb473a9f27f160afcf07132025-08-20T03:34:37ZengWileyCase Reports in Neurological Medicine2090-66682090-66762016-01-01201610.1155/2016/51308205130820Chronic Encapsulated Expanding Thalamic Hematoma Associated with Obstructive Hydrocephalus following Radiosurgery for a Cerebral Arteriovenous Malformation: A Case Report and Literature ReviewJun Takei0Toshihide Tanaka1Yohei Yamamoto2Akihiko Teshigawara3Satoru Tochigi4Yuzuru Hasegawa5Yuichi Murayama6Department of Neurosurgery, Jikei University School of Medicine Kashiwa Hospital, 163-1 Kashiwa-shita, Kashiwa, Chiba 277-8567, JapanDepartment of Neurosurgery, Jikei University School of Medicine Kashiwa Hospital, 163-1 Kashiwa-shita, Kashiwa, Chiba 277-8567, JapanDepartment of Neurosurgery, Jikei University School of Medicine Kashiwa Hospital, 163-1 Kashiwa-shita, Kashiwa, Chiba 277-8567, JapanDepartment of Neurosurgery, Jikei University School of Medicine Kashiwa Hospital, 163-1 Kashiwa-shita, Kashiwa, Chiba 277-8567, JapanDepartment of Neurosurgery, Jikei University School of Medicine Kashiwa Hospital, 163-1 Kashiwa-shita, Kashiwa, Chiba 277-8567, JapanDepartment of Neurosurgery, Jikei University School of Medicine Kashiwa Hospital, 163-1 Kashiwa-shita, Kashiwa, Chiba 277-8567, JapanDepartment of Neurosurgery, Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi, Minato-ku, Tokyo 105-8461, JapanChronic encapsulated intracerebral hematoma is a unique type of intracerebral hematoma accompanied by a capsule that is abundant in fragile microvasculature occasionally causing delayed regrowth. A 37-year-old man who had undergone radiosurgery for an arteriovenous malformation (AVM) causing intracerebral hematoma in the left parietal lobe presented with headache, vomiting, and progressive truncal ataxia due to a cystic lesion that had been noted in the left thalamus, leading to progressive obstructive hydrocephalus. He underwent left frontal craniotomy via a transsylvian fissure approach, and the serous hematoma was aspirated. The hematoma capsule was easy to drain and was partially removed. Pathological findings demonstrated angiomatous fibroblastic granulation tissue with extensive macrophage invasion. The concentration of vascular endothelial growth factor (VEGF) was high in the hematoma (12012 pg/mL). The etiology and pathogenesis of encapsulated hematoma are unclear, but the gross appearance and pathological findings are similar to those of chronic subdural hematoma. Based on the high concentration of VEGF in the hematoma, expansion of the encapsulated hematoma might have been caused by the promotion of vascular permeability of newly formed microvasculature in the capsule.http://dx.doi.org/10.1155/2016/5130820
spellingShingle Jun Takei
Toshihide Tanaka
Yohei Yamamoto
Akihiko Teshigawara
Satoru Tochigi
Yuzuru Hasegawa
Yuichi Murayama
Chronic Encapsulated Expanding Thalamic Hematoma Associated with Obstructive Hydrocephalus following Radiosurgery for a Cerebral Arteriovenous Malformation: A Case Report and Literature Review
Case Reports in Neurological Medicine
title Chronic Encapsulated Expanding Thalamic Hematoma Associated with Obstructive Hydrocephalus following Radiosurgery for a Cerebral Arteriovenous Malformation: A Case Report and Literature Review
title_full Chronic Encapsulated Expanding Thalamic Hematoma Associated with Obstructive Hydrocephalus following Radiosurgery for a Cerebral Arteriovenous Malformation: A Case Report and Literature Review
title_fullStr Chronic Encapsulated Expanding Thalamic Hematoma Associated with Obstructive Hydrocephalus following Radiosurgery for a Cerebral Arteriovenous Malformation: A Case Report and Literature Review
title_full_unstemmed Chronic Encapsulated Expanding Thalamic Hematoma Associated with Obstructive Hydrocephalus following Radiosurgery for a Cerebral Arteriovenous Malformation: A Case Report and Literature Review
title_short Chronic Encapsulated Expanding Thalamic Hematoma Associated with Obstructive Hydrocephalus following Radiosurgery for a Cerebral Arteriovenous Malformation: A Case Report and Literature Review
title_sort chronic encapsulated expanding thalamic hematoma associated with obstructive hydrocephalus following radiosurgery for a cerebral arteriovenous malformation a case report and literature review
url http://dx.doi.org/10.1155/2016/5130820
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