[Spontaneous subdural hemorrhage of natural cause in metastatic renal cell carcinoma]

A 51 years old woman was complaining about pain in the back and headache. Because of sudden change in behaviour she was brought into hospital by her husband. At hospitalization she was unconscious, the first examination showed no hints for trauma. After diagnosis of a bifrontal subdural haematoma intracranial blood was removed twice by neurosurgeons. The woman died six days after hospitalization. The forensic autopsy showed rests of subdural blood and apart of medical intervention no injuries were seen. In the left kidney a carcinoma was found with metastasation in the adrenal glands, the liver, and the dura. The metastasation of the dura had led to destruction of the dural vessels with consecutive subdural bleedings. These hemorrhages probably had been supported by decreased coagulation because of metastasation of the liver. Although such spontaneous non-traumatic subdural bleedings are rare it is obvious that they can cause severe problems by delivering an expert opinion.