Brain shift occurs when the dura is opened, cerebrospinal fluid leaks out, and the brain either shrinks or swells.
The brain showed extensive postsurgical changes, including a small occipital subdural hematoma, sutures within the dura , and a ventriculostomy tract in each frontal lobe.
The dural covering of the spinal cord also showed pigmentation adjacent to intervertebral disk.
In addition, an intra-operative lumbar spinal drain was used to facilitate atraumatic dural elevation and temporal lobe retraction.
Computed tomography of her brain was consistent with a dural sinus thrombosis, including a small frontal lobe haemorrhage.
The dura mater of the spinal cord is separated from the periosteum of the vertebrae by an epidural space.
Neuropathologic examination demonstrated massive distension of the entire dural venous sinus system by dark blue-purple thrombi.
There were prominent bilateral scalp contusions with soft tissue and intramuscular haemorrhage, symmetrical parietal skull fractures with coronal sutural diastasis, and a lacerated dura mater with extrusion of brain and blood.
Middle cranial fossa exploration revealed two punched out defects in the dura, with generalised dural thinning, overlying the tegmen and mastoid dural plate, which were eroded.
We report a case of prominent pigment deposition in the dura mater of the brain.