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Vol. 33. Issue 6.
Pages 340-344 (November - December 2022)
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Vol. 33. Issue 6.
Pages 340-344 (November - December 2022)
Case Report
Spontaneous acute bleeding within subdural effusion from dural metastasis of gastric cancer: A case report
Sangrado subdural agudo en el seno de una efusión subdural causada por una metástasis de cáncer gástrico: un caso clínico
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Alejandro Augusto Ortega Rodrigueza,
Corresponding author
aaortega.girona.ics@gencat.cat

Corresponding author.
, Carlos Miguel Cohn Reinosoa, Gemma Mateu Esquerdab, Jordi de Manuel-Rimbau Muñoza
a Department of Neurosurgery, Hospital Universitari de Girona Doctor Josep Trueta, Girona, Spain
b Department of Anatomical Pathology, Hospital Universitari de Girona Doctor Josep Trueta, Girona, Spain
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Abstract

Dural metastases are uncommon findings and at diagnosis normally appear in disseminated stages of malignant tumors. Usually clinically silent, these could become symptomatic due to mass effect or after developing subdural collections. We present the case of a young woman recently operated from gastric cancer who presented consciousness deterioration and hemiparesis caused by subdural collection. During examination, the patient drastically worsens his neurological status due to an acute subdural bleeding within the subdural collection, which after pathological analysis was diagnosed of dural metastasis of gastric cancer. In malignancies associated with subdural collections it is important to suspect the coexistence of dural metastases and performing a contrast enhanced CT scan or Magnetic Resonance Imaging (MRI) may help in the diagnosis. If surgery is indicated, it is mandatory to evacuate the tumor and involved dura which causes the accumulation of fluid and to coagulate the external tumor membrane to avoid re-bleeding.

Keywords:
Gastric cancer
Hemorrhage
Intracranial metastasis
Intradural
Subdural effusion
Resumen

Las metástasis durales son hallazgos infrecuentes, y al diagnosticarse, normalmente se encuentran en estadios diseminados de tumores malignos. Generalmente, son clínicamente silentes, pero pueden dar síntomas debido al efecto de masa o tras desarrollar colecciones subdurales. Presentamos el caso de una mujer joven, recientemente intervenida de cáncer gástrico, que presentó deterioro de la conciencia y hemiparesia por colección subdural. Durante la exploración, la paciente empeoró neurológicamente debido a un sangrado subdural agudo dentro de la colección subdural, que tras análisis patológico fue diagnosticada de metástasis dural de cáncer gástrico. En las neoplasias asociadas con colecciones subdurales es importante sospechar la coexistencia de metástasis durales y realizar una tomografía computarizada con contraste o una resonancia magnética puede ayudar en el diagnóstico. Si está indicada la cirugía es obligatorio evacuar el tumor y la duramadre afectada que provoca la acumulación de líquido y coagular la membrana tumoral externa para evitar el resangrado.

Palabras clave:
Cáncer gástrico
Hemorragia
Metástasis intracraneal
Intradural
Efusión subdural

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