SUBDURAL AND MENINGEAL INVOLVEMENT RELATED TO WEGENERS-GRANULOMATOSIS- CASE-REPORT

OBJECTIVE AND IMPORTANCE: The first case of Wegener's granulomatosis a ssociated with subdural empyema is presented. CLINICAL PRESENTATION: A 37-year-old man was admitted to our hospital for treatment of bilater al subdural masses. Magnetic resonance imaging demonstrated strong bil ateral subdural and meningeal enhancement. The patient was treated wit h subdural drainage, based on the diagnosis of bilateral subdural hema toma or empyema as revealed by magnetic resonance imaging. Even after surgery, he developed systemic symptoms that are typical for Wegener's granulomatosis, including hemosputum, papules, peripheral nervous dis orders, hematuria, myalgia, and joint pain. A diagnosis of Wegener's g ranulomatosis was confirmed by positive circulating antineutrophil cyt oplasmic antibodies and histological findings from the skin and nasal mucosa. We diagnosed the subdural masses as Wegener's granulomatosis f rom the laboratory and neuroimaging studies, retrospectively, INTERVEN TION: Pus-like fluid containing hematoma with negative microorganism w as evacuated by surgery. CONCLUSION: Wegener's granulomatosis should b e suspected in young patients with pulmonary symptoms and subdural hem atoma without head injury. This is the first case of Wegener's granulo matosis associated with subdural masses.