Post-traumatic chronic-encapsulated and calcified intracerebral hematoma mimicking a supratentorial hemangioblastoma: a case report and literature review

Abstract

Introduction and importance: Chronic-encapsulated intracerebral hematomas are a rare type of hematoma. They tend to be mistaken for abscesses or tumors. The etiology of these hematomas is not yet clear, although they have mainly been linked to arteriovenous malformations, cavernomas, and head trauma. Surgical evacuation is effective in improving neurological symptoms with a good prognosis. However, the lesion may be difficult to diagnose. Case presentation: Here, the authors report a case of a chronic-encapsulated and calcified intracerebral hematoma following recurrent mild head injuries mimicking a supratentorial hemangioblastoma in a healthy 26-year-old female patient presented with progressive raised intracranial pressure and left body heaviness with good outcomes after en bloc surgical resection. Clinical discussion: The chronic-encapsulated intracerebral hematoma was first described by Hirsh et al. in 1981. Their etiology is not yet clear, although they have mainly been linked to arteriovenous malformations, cavernomas, and head trauma. Pathologically, they are characterized by the presence of a fibrous capsule composed of an outer collagen layer and an inner granulated layer. Radiologically, they appear as cystic lesions with a homogeneous high signal on T1-weighted and T2-weighted images associated with a lower signal ring sign and ring enhancement after gadolinium administration that may suggest hemangioblastoma. Conclusion: Although chronic parenchymal hematomas remain a rare phenomenon, it has become increasingly logical to consider this entity in differential diagnoses with other lesions. In cases with recurrent head trauma, a detailed investigation will aid in making the diagnosis of such a rare pathology.