PMC5421363_01
Case one: (a) axial T1weighted magnetic resonance imaging defines anatomic location of the left sphenoidal wing meningioma, (b) early postoperative axial brain CT scan lacks any sign in favor of RCH, (c) late postoperative scan unmask RCH and (d) the scan just before patient discharge depicted resolution of hematoma
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F1
The brain imaging demonstrated an enhancing extra-axial mass in the left frontal lobe adjacent to the left carotid artery bifurcation in favor of inner third sphenoidal wing meningioma [Figure 1a]. Postoperative brain computed tomography (CT) scan showed a moderate volume of pneumocephalus bifrontally, little epidural hematoma, small contusions, and hematoma in the surgical field [Figure 1b]. Control CT scan showed cerebellar linear hemorrhage (zebra sign) and an intracerebellar hemorrhage of about 35 x 8 mm2 with no mass effect on the fourth ventricle [Figure 1c]. The hematoma resolved after approximately 10 days and the patient was discharged with satisfactory recovery [Figure 1d].
PMC5421363_02
Case two: (a and b) preoperative CTscan demonstrated posterior fossa and supratentorial tumor, (c and d) the first scan postoperation showed linear hemorrhage in posterior fossa in favor of RCH and blood in surgical field and (e) the second scan postoperation demonstrated the exacerbated hemorrhage
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F2
Physical exam was normal; whereas the brain imaging demonstrated a huge intraaxial mass in the parietooccipital lobe originating from lateral ventricle associated with calcification [Figure 2a and b]. The postoperative CT scan showed the hemorrhage in the surgical field and in the cerebellar sulci in favor of RCH [Figure 2c and d]. The control CT scan showed a raised amount of hematoma in cerebellar sulci [Figure 2e].