Chronic Encapsulated Intracerebral Hematoma

Abstract

Intracerebral hematomas producing chronic neurological disability are reported rarely. Two cases of chronic intracerebral hematoma are described. Each case was associated with a thick, fibrous capsule found histologically to arise from an occult vascular malformation. When such encapsulation is discovered surgically, a vascular anomaly must be suspected.

A Chronic Intracerebral Fluid Hematoma

“…Chronic encapsulated intracerebral hematoma (CEIH) was first reported in 1981 3 . CEIH is reported to be associated with vascular malformations such as cavernous angioma or arteriovenous malformation 4,6 .…”

“…However, it occasionally develops a mass after a period of time 1 that may cause neurological deficits in a patient and be misdiagnosed as a brain tumor 8 . Although several reports describing chronic encapsulated intracerebral hematoma (CEIH) have been published 2,3,6,7 , a fluid hematoma without encapsulation is rare. We describe a case of chronic fluid hematoma without encapsulation and discuss the characteristics of this rare condition.…”

Chronic expanding intracerebral hematoma

“…In the literature, its pathological features were described as chronic encapsulated intracerebral hematoma, while its clinical manifestations were reported as chronic expanding intracerebral hematoma. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] Hirsh et al 16 reported two cases of chronic encapsulated intracerebral hematoma in 1981. In 1983, Takahashi et al 3 reported one case of multilocular encapsulated intracerebral hematoma.…”

“…Twelve cases were thought to be caused by occult vascular malformation in 26 cases of CEICHs summarized by Roda et al 7 Vascular malformations as bleeding origin accounted for 29% in 31 cases according to the cases reported in the literature. 1;3-7;10-12; 16 Recently, Yamamoto et al 15 reported three cases of spontaneous intracerebral hematomas expanding during the early stages of hemorrhage without rebleeding. Head injury and hypertension may be the occasional causes of CEICH, which can lead to abnormal vessel bleeding.…”

“…1;2;6;12 The formation of capsule may originate from the fibrocytes in the abnormal vessels related to occult vascular malformations. 16 …”