Surgical Findings

[cypercat]

After undergoing a craniotomy to evacuate an acute right subdural hematoma. Surgeon stated that the surface of my brain was noted to be covered with an abnormal venous pattern that seemed to drain anteriorly in an abnormal pattern superior to the sylvian fissure. He also stated that the arachnoid was thickened and the subarachnoid space was enlarged. There also were seen to be several anomalous venous structures draining into the the sagittal sinus medially.

He hasn't said anymore about this - does anyone know if I should be following up with someone regarding this? or is this just how my brian works - different.

The subdural hematoma was from a hit to the head causing a large subdural hematoma and 1.2cm midline shift.

[cypercat]

Thank you - you mentioned "chronic fibroinflammatory" does that mean anything per say or is its just a result of the subdural hematoma and I will always have this show up - or does this clear up after time. Does it cause any symptoms (headaches, pressure, nausea)

I do plan on asking why he didn't order the MRA - because we talked mainly about the findings from his report. So I am confused why he didn't order that to be done.

You have been very helpful.

[Godofredo MD]

Hi.

The dural thickening would suggest an inflammatory process and would represent a chronic fibroinflammatory finding. It can be associated with the subdural hematoma that you experienced before.

Yes, you are correct. Cerebrobascular malformations or anomalies would be better seen in a MR angiography. You could ask your surgeon why this was not done. Does he not consider this as a serious condition?

Hope this helps.

[cypercat]

After above posts had a conversation with neurosurgeon. He wanted an MRI this is the impressions. Any thoughts anyone? The only thing to me that might be concerning (on small scale) would be the dural thickening. Does the thickening of the dural mean anything at all?

Mild residual dural thickening is seen overlying the right cerebral convexity which is of intermediate signal on T1 and T2/FLAIR imaging. No residual subdural or extradural collection is identified. Numerous foci of susceptibility artifact are seen overlying the right cerebral convexity from prior surgery.

I also thought that the only way you can see malformations was with an MRA but he didn't order an MRA just a MRI. I haven't met with him yet to discuss. Know of any questions that I might ask?

Thanks

[Godofredo MD]

Hi.

It would depend on how "abnormal" they are. Some people have cerebrovascular anomalies that predispose them to intracranial bleeding at even a minor hit on the head. However, while a person's skull may be harder than the next guy, everyone's brain is fragile, and any amount of force at the right spot can cause a hematoma.

Hope this answers your query.

[cypercat]

Thanks for the quick response - heading out for the night and thought I would check back.

I am 19 years old - No I didn't have any symptoms except for occasional headache and nose bleeds.  Don't have a real follow up plan with surgeon. I guess I could call and set one up.  Could these abnormal veins caused or predisposed me to the subdural hematoma. The hit seemed minor.

[Godofredo MD]

Hi.

How old are you now? Prior to experiencing the subdural hematoma, did you have any symptoms that would point to a neurological disorder?

If you are concerned about these findings, it would be best to talk to your neurosurgeon about it and determine whether this is nothing to be worried about or if you have a cerebrovascular condition that needs medical attention.

Hope this helps.