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Huge chronic subdural haematoma formation in an encephalomalacia stroke cavity
  1. Andres Monserrate and
  2. Orlando De Jesus
  1. Neurosurgery, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
  1. Correspondence to Dr Orlando De Jesus; drodejesus{at}


A patient suffering from a cerebrovascular ischaemic stroke may present similar symptoms to a patient with a chronic subdural haematoma (CSDH). Head CT imaging of an old extensive hemispheric infarction may appear hypodense in a similar fashion as CSDH. We described a 46-year-old man with a 2-week history of mild headache and worsening right lower extremity hemiparesis. Eight years prior, he suffered a left middle cerebral artery territory infarct. The head CT scan showed a huge, slightly hypodense area on the left brain, causing a significant mass effect. A new stroke was of concern versus a chronic subdural haematoma inside the old encephalomalacia stroke cavity. Only three previously reported cases of CSDH occupying an encephalomalacic cavity had been reported. This rare presentation should be considered in the differential diagnosis in patients with a history of cerebrovascular stroke. MRI is useful in making a correct diagnosis.

  • stroke
  • neuroimaging
  • trauma CNS /PNS
  • neurosurgery
  • neurological injury

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  • Contributors All authors (AM and ODJ) contributed equally to the design, planning, data, interpretation and preparation of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.