Chronic intraventricular encapsulated hematoma presenting unique radiological features: a case report

Abstract

Background: Chronic encapsulated hematoma is relatively rare and the exact mechanisms of this condition remain uncertain. In this report, we present a case of chronic encapsulated hematoma in the lateral ventricle and discuss the pathophysiology of this condition.

Case description: A 68-year-old-woman presented with progressive gait disturbance. Magnetic resonance imaging (MRI) showed a dumbbell-shaped mass arising from the wall of the right lateral ventricle. The mass connecting to the ventricle wall mimicked a hemorrhagic tumor and the other part mimicked a cystic mass. Cerebral angiography demonstrated arteriovenous shunt in the right lateral ventricle wall. The operative findings revealed that the part arising from the ventricle wall contained hematoma showing various stages of coagulation and that the cystic mass visible on MRI was a granulomatous solid mass. Histologic examination revealed that the capsules of both were compatible with chronic encapsulated intracerebral hematomas.

Conclusion: In the present case, one part of the mass contained only granulomatous tissue, indicating the possibility that the mass was undergoing spontaneous resolution. This fact might indicate that the presence of neo-vascularization in the capsule is not the sole factor in the expansion of hematoma.