Bilateral Chronic Subdural Nontraumatic Hematoma in a Woman Affected by AL Amyloidosis

Abstract

Chronic subdural hematoma (CSDH) is a condition frequently seen in neurosurgical practice, especially among the elderly. It is often preceded by head injury, even a trivial trauma. Light chain (AL) amyloidosis is a disorder involving extracellular tissue deposition of misfolded native proteins called amyloids. The several types of amyloidosis differ by source of proteins, organ involvement, treatment, and prognosis. We describe the case of a 59-year-old woman affected by AL amyloidosis, harboring surgically treated bilateral chronic nontraumatic subdural hematoma, and we suggest a possible correlation between the clinical entities of CSDH and AL amyloidosis.

Keywords

chronic subdural hematoma - AL amyloidosis - headache - acute subdural bleeding - amyloids - vessel fragility

• References

• 1 Kyle RA, Linos A, Beard CM , et al. Incidence and natural history of primary systemic amyloidosis in Olmsted County, Minnesota, 1950 through 1989. Blood 1992; 79 (7) 1817-1822
• 2 Merlini G, Bellotti V. Molecular mechanisms of amyloidosis. N Engl J Med 2003; 349 (6) 583-596
• 3 Penchet G, Loiseau H, Castel JP. Chronic bilateral subdural hematomas [in French]. Neurochirurgie 1998; 44 (4) 247-252
• 4 Matsuda M, Gono T, Shimojima Y , et al. AL amyloidosis manifesting as systemic lymphadenopathy. Amyloid 2008; 15 (2) 117-124
• 5 Kyle RA, Greipp PR. Amyloidosis (AL). Clinical and laboratory features in 229 cases. Mayo Clin Proc 1983; 58 (10) 665-683
• 6 Yood RA, Skinner M, Rubinow A, Talarico L, Cohen AS. Bleeding manifestations in 100 patients with amyloidosis. JAMA 1983; 249 (10) 1322-1324
• 7 Greipp PR, Kyle RA, Bowie EJ. Factor-X deficiency in amyloidosis: a critical review. Am J Hematol 1981; 11 (4) 443-450
• 8 Wettlé C, Springinsfeld G, Lipsker D. Haemorrhage and amyloidosis—response to Veneri et al. Br J Haematol 2013; 160 (6) 854-855
• 9 Mumford AD, O'Donnell J, Gillmore JD, Manning RA, Hawkins PN, Laffan M. Bleeding symptoms and coagulation abnormalities in 337 patients with AL-amyloidosis. Br J Haematol 2000; 110 (2) 454-460
• 10 Veneri D, Pizzolo G, Bonalumi A, Franchini M. Haemorrhage and amyloidosis. Br J Haematol 2013; 160 (6) 854
• 11 Luongo M, Pizzuti M, Godano U. Bilateral chronic subdural non-traumatic hematoma associated with von Willebrand's type I disease: a case report. Acta Neurochir (Wien) 2012; 154 (6) 1087-1088
• 12 Luongo M, Pizzuti M, Godano U. Chronic subdural non traumatic hematoma associated with von Willebrand's disease: a real clinical association or just a mere coincidence?. Clin Neurol Neurosurg 2013; 115 (8) 1569-1570
• 13 Manikkan AT. Factor X deficiency: an uncommon presentation of AL amyloidosis. Ups J Med Sci 2012; 117 (4) 457-459