Relationship between imaging, anatomical, and histological characteristics of chronic subdural hematoma membranes

Abstract

Background: Chronic subdural hematoma is defined as a collection of blood-derived substances located in the subdural space, which occurs secondary to head trauma, identified as the most frequent cause.

Objective: To describe the relationship between the radiological characteristics with the macroscopic and histological characteristics of chronic subdural hematoma membranes by presenting a clinical case.

Case presentation: An 89-year-old mixed-race male with a history of hypertension, prostate adenocarcinoma and a previous surgery in 2022 for a heterogeneous, trabeculated left chronic subdural hematoma with visible visceral membrane, for which he underwent craniotomy with membranectomy and histological examination of the membranes. He presented in 2024 with neurological symptoms including temporospatial disorientation and stupor. The patient also reported a history of head trauma two weeks prior to admission. A computed tomography scan diagnosed a right isodense chronic subdural hematoma with a visible and slightly thick visceral membrane, indicating a craniotomy with membranectomy and histological examination of the membranes. Radiological, macroscopic, and histological images from both surgeries are available.

Conclusions: The radiological characteristics observed of the visceral membrane, as well as the density of the hematoma, were correlated with the macroscopic features observed during surgery and the histological particularities of the hematoma membranes.