Dural Metastasis with Subdural Hemorrhage from Prostate Cancer

A subdural hematoma (SDH) is usually traumatic in etiology. Non-traumatic instances of SDH are uncommon, and are rarely due to metastases involving the dura. We report a 68-year-old male patient with a one day history of, not communicating and not mobilizing and a 2 weeks history of generalized body weakness. A computed tomography (CT) scan revealed a left sided hypo-dense subdural collection. A diagnosis of left sided chronic subdural hematoma (SDH) was made. Burr hole drainage of the hematoma was performed. Intra- operatively, liquefied blood was drained and a thick dura with reddish material infiltrating the dura was noted. A specimen of the dura was submitted for histology and revealed metastatic carcinoma, confirmed at immunohistochemistry to be of prostatic origin. Conclusion: Metastatic disease should be considered when there is a chronic subdural hematoma with no history of trauma and an unusual dural appearance on imaging.