PMC7533084_01
PMC7533084_02
(a and b) Head computed tomography in soft tissue and bone window, showing a spontaneously hyperdense left frontal rounded lesion with ipsilateral subdural hemorrhage and the hyperostotic bone reaction.
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F1
Head computed tomography (CT) showed a subacute left hemisphere and tentorial subdural hemorrhage with 17 mm of maximum width and signs of acute hemorrhage in the frontal region, as well as a left frontal dural-based lesion, well-demarcated, spontaneously hyperdense, and partially calcified, measuring 15 mm x 18 mm in diameter, causing surrounding edema and mass effect, inducing a 10 mm midline shift [Figure 1].
PMC7533084_03
(a and b) Axial and coronal T2-weighted head magnetic resonance imaging confirming the presence of the left frontal lesion with adjacent subdural hemorrhage causing important mass effect and right midline shift.
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F2
The patient was then admitted to the neurosurgery ward and head magnetic resonance imaging (MRI) confirmed an extra- axial left frontal lesion with adjacent dural enhancement after intravenous contrast [Figure 2].
PMC7533084_04
(a and b) Intraoperative images of meningioma exposure after major subdural hemorrhage evacuation.
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F3
The dural opening revealed subacute subdural hemorrhage and a yellowish rounded lesion, very well delimited, that was carefully separated from [Figure 3] the cortical surface, preserving the arachnoid membrane, and removed with the adjacent dural thickening (Simpson I).
H and E x25, in the left corner, we see the subdural hematoma membrane detached from the meningioma periphery. At the right corner, the transitional meningioma is shown.
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F4
The adjacent dura mater showed signs of fibrovascular proliferation [Figures 4 and 5] and hemosiderin deposits, both intra- and extracellularly.
H and E x100, in the left upper corner: subdural hematoma membrane (superior) and the dura-mater (inferior) infiltrated by erythrocytes.
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F5
The adjacent dura mater showed signs of fibrovascular proliferation [Figures 4 and 5] and hemosiderin deposits, both intra- and extracellularly.
PMC7533084_05
Axial T1-weighted head magnetic resonance imaging 6-month postoperatively showing no signs of the previous lesions.
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F6
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