'The subdural collection' a great simulator!
Prostate carcinoma rarely develops intracranial metastasis. In case it does, the dura is the most affacted area. In general, brain computed tomography (CT) findings mimic subdural hematoma making surgery challenge.

Published in Asian Journal of Neurosurgery, the authors report the case of a 52-year-old male who presented in the emergency with a month history of headache, progressive temporospatial disorientation, mental confusion, and abrupt consciousness deterioration up to coma occurring few hours prior admission.

An urgent brain CT scan showed a subdural collection in favor of a chronic subdural hematoma. The patient underwent surgery by standard burr hole, and surprisingly, peroperatively, there was a very bloody diffuse thickening of the dura without a real hematoma obliging to switch to a large fronto-temporoparietal craniotomy revealing a subdural mass that was completely removed.

Histopathology disclosed a metastatic prostatic carcinoma confirming that such a subdural collection could behave as a great simulator.

Key takeaway:-
- A contrast brain CT scan, is advisable, even in emergency, in selected case, with atypical images finding, especially if, a malignant disease is already known; the former could be of great help in the differential diagnosis and the best prompt management.

Read more here: https://pxmd.co/E9Irn