Subdural hematoma: a rare presentation of a convexity meningioma.

CASE PRESENTATION a 69-year-old male presented to a peripheral emergency department with a several day history of increasing confusion and headache. on admission, his glasgow Coma Scale (gCS) score was 10 (e3 m6 v1). he was mute but would obey commands intermittently. Cranial nerve exam was normal and there was no evidence of weakness. a computed tomogram (Ct) head (figure 1) showed a chronic subdural hematoma with midline shift, as well as a mass within the left frontal region that appeared consistent with a convexity meningioma seen on magnetic resonance imaging (mri) two years prior (figure 2). the patient was not on any blood thinners and had no history of falls. past medical history also included hypertension and prostate cancer. MANAGEMENT AND OUTCOME over the course of the night, the patient’s gCS deteriorated to 8 and he required intubation. he was brought to the operating room and underwent left craniotomy. intra-operatively we found a subacute clot attached to the tumor (figure 3) and final pathology confirmed Who grade 1. patient was transferred to local hospital for ongoing rehabilitation after significant improvement post-surgery.