n e u r o c i r u g i a . 2 0 1 4; 2 5(3) :128–131 NEUROCIRUGÍA www. e lsevier.es/neurocirugia Case Report Non-traumatic spontaneous acute epidural hematoma in a patient with sickle cell disease  Yurdal Serarslan a,* , Mustafa Aras a , Murat Altas ¸ a , Hasan Kaya b , Boran Urfalı a a Mustafa Kemal University, Tayfur Ata Sökmen Medical Faculty, Department of Neurosurgery, Hatay, Turkey b Mustafa Kemal University, Tayfur Ata Sökmen Medical Faculty, Department of Haematology, Hatay, Turkey a r t i c l e i n f o Article history: Received 16 February 2013 Accepted 1 August 2013 Available online 18 January 2014 Keywords: Epidural hematoma Mechanism Pathophysiology Sickle cell Sickle cell disease Spontaneous epidural hematoma a b s t r a c t A 19-year-old female with sickle cell anemia (SCD) was referred to our hospital after two days of hospitalization at another hospital for a headache crisis. This headache crisis was due to a raised intracranial pressure; these symptoms were noted and included in her comprehen- sive list of symptoms. There was an acute drop in the hemoglobin and hematocrit levels. The cranial CT scan demonstrated a left fronto-parietal acute epidural hematoma (AEH) and a calvarial bone expansion, which was suggestive of medullary hematopoiesis. The patient underwent emergent craniotomy and evacuation of the hematoma. There were no abnormal findings intra-operatively apart from the AEH, except skull thickening and active petechial bleeding from the dural arteries. Repeated CT scan showed a complete evacuation of the hematoma. The possible underlying pathophysiological mechanisms were discussed. In addition to the factors mentioned in the relevant literature, any active petechial bleeding from the dural arteries on the separated surface of the dura from the skull could have con- tributed to the expanding of the AEH in our patient. Neurosurgeons and other health care providers should be aware of spontaneous AEH in patients with SCD. © 2013 Sociedad Española de Neurocirugía. Published by Elsevier España, S.L. All rights reserved. Hematoma epidural agudo espontáneo no traumático en una paciente con enfermedad de células falciformes Palabras clave: Hematoma epidural Mecanismo Patofisiología Célula falciforme Enfermedad de las células falciformes Hematoma epidural espontánea r e s u m e n Una mujer de 19 a˜ nos con anemia de células falciformes (anemia drepanocítica) fue remi- tida a nuestro hospital tras 2 días de hospitalización en otro centro, debido a una crisis de migra ˜ na. Dicha crisis de migra ˜ na fue debida a un incremento de la presión intracraneal; se anotaron dichos síntomas y se incluyeron en su amplia lista de síntomas. Se produjo un pico agudo en los niveles de hemoglobina y de hematocrito. El escáner craneal mostró un hematoma epidural agudo fronto-parietal izquierdo y una expansión del hueso de la bóveda craneal, que indicaba una hematopoyesis medular. Se sometió a la paciente a una  The paper was presented as an electronic poster in the 9th Asian Congress of Neurological Surgeons, September 2–5, 2012, Istanbul, Turkey. * Corresponding author. E-mail addresses: yserarslan@yahoo.com, yserarslan@gmail.com (Y. Serarslan). 1130-1473/$ – see front matter © 2013 Sociedad Española de Neurocirugía. Published by Elsevier España, S.L. All rights reserved. http://dx.doi.org/10.1016/j.neucir.2013.08.003 Documento descargado de http://www.revistaneurocirugia.com el 04/01/2017. Copia para uso personal, se prohíbe la transmisión de este documento por cualquier medio o formato.