Spontaneous intracerebral hematomas expanding during the early stages of hemorrhage without rebleeding. Report of three cases.
ABSTRACT Expansion of intracerebral hematoma usually occurs in the chronic phase because of repeated bleeding from pre-existing vascular anomalies or exudation of blood from capillaries of the capsule. In contrast, spontaneous intracerebral hematoma expanding during the acute phase of hemorrhage without rebleeding is seldom seen. Three such cases are reported, along with magnetic resonance (MR) and computerized tomography (CT) follow-up studies. The follow-up MR images and CT scans demonstrated no evidence of rebleeding, but revealed gradual expansion of a fluid component of the hematoma, beginning in the acute phase. Volume alterations posthemorrhage are carefully documented. There was a characteristic phenomenon of layering, with the red blood cell component of the clot settling by gravity and the serum separating as well as seen in a test tube, depending on whether a preservative was used. Examination of blood samples indicated a possible correlation between expansion of the hematoma and the activities of both the fibrinolytic system and coagulation factors.
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ABSTRACT: Chronic expanding hematoma is a rare condition that develops after surgery, trauma, or injury. It can also develop at any location in the body in the absence of trauma. Clinical findings and various diagnostic imaging modalities can aid in the differential diagnosis of this condition. In general, hematomas are naturally reabsorbed and rarely cause serious problems. However, hematomas that develop slowly without a history of trauma, surgery, or bleeding disorders could be difficult to differentiate from soft tissue neoplasms. In the present case, we describe a patient, without any history or physical evidence of trauma, who exhibited a large chronic expanding hematoma in the retroperitoneal space that resulted in hydronephrosis because of the pressure exerted on the left ureter. A 69-year-old man presented to our hospital with a swollen lesion in the left flank. A mass, 19 cm in diameter, was detected in the retroperitoneal space by computed tomography. We suspected the presence of a chronic expanding hematoma, soft tissue tumor, or left renal artery aneurysm. Surgical treatment was performed. However, postoperative histopathological examination indicated that the mass was a nonmalignant chronic expanding hematoma. No recurrence was observed during a 2-year follow-up period. In patients without a history of trauma who present slowly growing masses, the differential diagnosis should include chronic expanding hematoma in addition to cysts and soft tissue tumors. Moreover, the use of magnetic resonance imaging and computed tomography is essential to differentiate between chronic expanding hematoma and soft tissue tumors.BMC Urology 11/2013; 13(1):60. · 1.69 Impact Factor
- Revista de neurologia 01/1986; 49(4):223-4. · 1.18 Impact Factor
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ABSTRACT: A case of retroperitoneal chronic expanding hematoma complicated with hydronephrosis, which was difficult to diagnose preoperatively, is reported. The patient was a 70-year-old man. An 18 cm mass was detected in the right retroperitoneal space on abdominal CT screening. There were small calcifications in the periphery of the mass that were strongly enhanced in the delayed phase of dynamic CT. The mass involved the right ureter and iliopsoas muscle, resulting in severe hydronephrosis. The histological diagnosis was chronic expanding hematoma.Radiation Medicine 04/2005; 23(2):116-20.