Cystic Lesion Growing Like Abscess Developing after Chronic Subdural Hematoma Drainage

Abstract

Chronic subdural hematoma and cranial abscess are two phenomena that are easy to differentiate in daily neurosurgical practice. Although the neurological symptoms may be the same in both, today’s imaging techniques and laboratory facilities are helpful for a definitive diagnosis. In this study, a patient who was operated on for a subdural hematoma came to the emergency room after 1 month with distinct hemiparesis appearing in the right arm and speech difficulties. Hospitalized due to the appearance of an abscess, which had a pachys capsule, keeping the contrast in the left parietal in the cranial CT and MR, the patient was operated on, and the mass was excised, along with the capsule. The lesion of the patient, which showed no reproduction in the culture, was diagnosed as a growing hemorrhagic cystic lesion, covered by a thick capsule. The literature showed no such growing cystic lesion causing a shift like an abscess after chronic subdural hematoma operation. We believe that it would be appropriate to consider a differential diagnosis, besides diagnoses, such as abscess or subdural empyema. Do we evaluate cystic lesion like abscess such as inflammatory response.