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Context.--Spontaneous (nontraumatic) subdural hematomas have been reported yet have not been well studied. Objective.--To identify the neuropathologic features of acute spontaneous SDHs (ASSDHs) and their associated medical conditions. Design.--A retrospective study of 235 autopsy cases of SDH was conducted. Review of demographics, underlying medical conditions, and coagulation profile as well as gross and histopathologic examination of the brain and other organs were performed. Results.--Among the 32 cases of ASSDH, 5 cases (15.6%) had severe hemorrhage and 4 (12.5%) demonstrated brain herniation. Twenty-two cases (68.8%) had concurrent but nonconnecting subarachnoid hemorrhage or intraparenchymal hemorrhage. The most common underlying medical condition was thrombocytopenia (n = 21; 65.6%), followed by immunosuppression (n = 15; 46.9), bloodstream infections or sepsis (n = 12; 37.5%), hypertension (n = 13; 40.6%), and coronary artery disease (n = 12; 37.5%). Many patients with thrombocytopenia or immunosuppression had underlying malignancies, with leukemia being the most common type (n = 11; 34.4%). The use of circulatory devices or hemodialysis was noted in a significant portion of ASSDH cases. In terms of coagulation factors, most of our ASSDH patients had normal prothrombin time and activated partial thromboplastin time, but abnormal platelet count and D-dimer levels. Conclusions.--ASSDHs can be severe and are often associated with subarachnoid hemorrhage and/or intra-parenchymal hemorrhage. The causes of ASSDH are limited to certain underlying medical conditions that ultimately lead to bleeding tendency. Autopsies are helpful in determining the etiology. Given their association with abnormal platelet count, correcting platelet deficiencies is a potential preventive measure for ASSDHs. doi: 10.5858/arpa.2024-0003OA, Subdural hematomas (SDHs) are collections of blood between the dura mater and leptomeninges, typically due to shearing of bridging veins as a result of trauma. (1) SDHs can occur in [...]

This article discusses the case of a 46-year-old woman who presented with new onset seizures. Magnetic resonance imaging (MRI) revealed a mass in the right posterior frontal lobe. The patient underwent surgery for resection of the mass, but follow-up imaging showed tumor recurrence. Histologic analysis revealed a glial neoplasm with certain molecular alterations. The case highlights the challenges of classifying central nervous system tumors based on molecular profiling and emphasizes the need for an integrated approach to diagnosis. [Extracted from the article]

A retrospective population-based study to investigate racial and socioeconomic disparities in patients diagnosed with ocular surface squamous neoplasia (OSSN). To explore racial disparity, we selected OSSN patients with known age, insurance, gender and zip code-level income and education from the National Cancer Database (NCDB). Comparisons of clinical and socioeconomic variables stratified by race were made with the chi-square or Mann-Whitney tests. Survival outcome was examined a Cox regression model. Of the 2,402 identified patients from 2004 to 2015, 117 were black. Unadjusted differences were found between groups in regard to age, histology, insurance, income, and education. Black patients in comparison to white patients were younger (mean age: 62 years vs. 70 years; p <.001), represented a higher proportion of Medicaid use (10.3% vs. 3.2%; p <.001) or uninsured (10.3% vs. 2.7%; p <.001), and were more likely to reside in areas of low educational attainment (32.5% vs. 16.1% of whites; p <.001). Multivariate analysis found significantly higher risk of death in patients who were male (HR: 1.66, 95% CI 1.37–2.01) or black (HR: 1.57, 95% CI 1.03–2.38). Disparities in socioeconomic factors were observed in black patients with OSSN. OSSN occurred earlier in blacks, who were also socioeconomically disadvantaged and faced higher risk of death. [ABSTRACT FROM AUTHOR]