Metastatic hepatocellular carcinoma presenting as epidural hematoma: Case report

OBJECTIVE AND IMPORTANCE: A case of acutely symptomatic epidural hematoma c aused by metastatic hepatocellular carcinoma (HCC) to the cranium is report ed. This is a rare case of metastatic HCC without known primary presenting as an epidural hematoma. CLINICAL PRESENTATION: The patient presented with an acute onset of headach e, aphasia, and right hemiparesis 2 weeks after he experienced minor trauma to the cranium. An emergency computed tomographic scan of the head reveale d the presence of a left parietal epidural hematoma. INTERVENTION: An emergency evacuation of the epidural hematoma was performe d, and metastatic HCC was diagnosed. CONCLUSION: The patients neurological deficits were reversed with surgical intervention, and he is now undergoing palliative chemotherapy. This was th e first clinical manifestation of HCC in this patient. This case reaffirms the neurosurgeon's role in the complex, multidisciplinary care of patients with craniospinal metastasis.