{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T22:27:58Z","timestamp":1769725678697,"version":"3.49.0"},"reference-count":42,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","license":[{"start":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T00:00:00Z","timestamp":1754870400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Cosmet Laser Ther"],"published-print":{"date-parts":[[2025,8,11]]},"abstract":"\n BACKGROUND<\/jats:title>\n Intracranial involvement in multiple myeloma (MM) is a rare clinical presentation, often mimicking other conditions such as subdural hematoma (SDH) and resulting in poor prognosis.<\/jats:p>\n <\/jats:sec>\n \n OBSERVATIONS<\/jats:title>\n This case series highlights 2 older female patients, one with a prior diagnosis of MM, who developed subdural masses resembling SDH. Both cases were associated with significant cerebral edema and mass effect. Biopsies confirmed plasma cell neoplasms, and both patients underwent tailored treatment, including corticosteroids, radiation therapy, and systemic chemotherapy. The patients showed clinical and radiographic improvement posttreatment.<\/jats:p>\n <\/jats:sec>\n \n LESSONS<\/jats:title>\n These cases underscore the importance of maintaining a broad differential in patients with subdural collections, particularly if associated with significant vasogenic edema or in those with a history of MM. Nonoperative management is effective, despite mass effect.<\/jats:p>\n \n https:\/\/thejns.org\/doi\/10.3171\/CASE25347<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/case25347","type":"journal-article","created":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T23:43:49Z","timestamp":1754955829000},"source":"Crossref","is-referenced-by-count":0,"title":["Intracranial multiple myeloma masquerading as subdural hematoma: illustrative cases"],"prefix":"10.3171","volume":"10","author":[{"given":"Stephanie A.","family":"Ihezie","sequence":"first","affiliation":[{"name":"Department of Surgery, Section of Neurosurgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0647-7826","authenticated-orcid":true,"given":"Vishva","family":"Natarajan","sequence":"additional","affiliation":[{"name":"Department of Surgery, Section of Neurosurgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George","family":"Zanazzi","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire"},{"name":"Dartmouth Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Swaroopa","family":"PonnamReddy","sequence":"additional","affiliation":[{"name":"Dartmouth Cancer Center, Section of Hematology\/Oncology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fredrick","family":"Lansigan","sequence":"additional","affiliation":[{"name":"Dartmouth Cancer Center, Section of Hematology\/Oncology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linton T.","family":"Evans","sequence":"additional","affiliation":[{"name":"Department of Surgery, Section of Neurosurgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Surgery, Section of Neurosurgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"10","key":"bib1","series-title":"Neuroradiology","first-page":"735","volume":"42","author":"De Blay","year":"2000","unstructured":"De Blay VMisson NDardenne GDupuis MJM.Leptomeningeal myelomatosis mimicking a subdural haematoma. Neuroradiology. 2000;42(10):735-737."},{"issue":"4","key":"bib2","series-title":"Am J Hematol","first-page":"228","article-title":"Cerebral and meningeal multiple myeloma after autologous stem cell transplantation. A case report and review of the literature","volume":"62","author":"Petersen","year":"1999","unstructured":"Petersen SLWagner AGimsing P.Cerebral and meningeal multiple myeloma after autologous stem cell transplantation. A case report and review of the literature. Am J Hematol. 1999;62(4):228-233."},{"issue":"1","key":"bib3","series-title":"J Clin Neurosci","first-page":"122","article-title":"Intracranial multiple myeloma involving the dura","volume":"13","author":"Tsang","year":"2006","unstructured":"Tsang CSHo LCTan TC.Intracranial multiple myeloma involving the dura. J Clin Neurosci. 2006;13(1):122-123."},{"issue":"3","key":"bib4","series-title":"Neurol Neurochir Pol","first-page":"252","article-title":"Intracranial multiple myeloma may imitate subdural hemorrhage: how to overcome diagnostic limitations and avoid errors in treatment","volume":"51","author":"Prajsnar-Borak","year":"2017","unstructured":"Prajsnar-Borak ABalak NVon Pein HGlaser MBoor SStadie A.Intracranial multiple myeloma may imitate subdural hemorrhage: how to overcome diagnostic limitations and avoid errors in treatment. Neurol Neurochir Pol. 2017;51(3):252-258."},{"key":"bib5","series-title":"World Neurosurg","first-page":"247","article-title":"IgG4-related disease in the frontal convexity concomitant with smoldering multiple myeloma: a case report and review of the literature regarding therapeutic implications","volume":"143","author":"Tanaka","year":"2020","unstructured":"Tanaka TFuga MTeshigawara AIgG4-related disease in the frontal convexity concomitant with smoldering multiple myeloma: a case report and review of the literature regarding therapeutic implications. World Neurosurg. 2020;143:247-260."},{"issue":"6","key":"bib6","series-title":"Am J Hematol","first-page":"575","article-title":"Central nervous system involvement by multiple myeloma: a multi-institutional retrospective study of 172 patients in daily clinical practice","volume":"91","author":"Jurczyszyn","year":"2016","unstructured":"Jurczyszyn AGrzasko NGozzetti ACentral nervous system involvement by multiple myeloma: a multi-institutional retrospective study of 172 patients in daily clinical practice. Am J Hematol. 2016;91(6):575-580."},{"issue":"22","key":"bib7","series-title":"Blood","first-page":"2401","article-title":"Efficacy of venetoclax as targeted therapy for relapsed\/refractory t(11;14) multiple myeloma","volume":"130","author":"Kumar","year":"2017","unstructured":"Kumar SKaufman JLGasparetto CEfficacy of venetoclax as targeted therapy for relapsed\/refractory t(11;14) multiple myeloma. Blood. 2017;130(22):2401-2409."},{"issue":"7","key":"bib8","series-title":"J Cancer","first-page":"1151","article-title":"Venetoclax penetrates the blood brain barrier: a pharmacokinetic analysis in pediatric leukemia patients","volume":"14","author":"Badawi","year":"2023","unstructured":"Badawi MMenon RPlace AEVenetoclax penetrates the blood brain barrier: a pharmacokinetic analysis in pediatric leukemia patients. J Cancer. 2023;14(7):1151-1156."},{"key":"bib9","series-title":"Onco Targets Ther","first-page":"3373","article-title":"Multiple myeloma with dural mater involvement","volume":"12","author":"Liu","year":"2019","unstructured":"Liu SLi XLi YLi DWang YTian C.Multiple myeloma with dural mater involvement. Onco Targets Ther. 2019;12:3373-3375."},{"issue":"7","key":"bib10","series-title":"No Shinkei Geka","first-page":"649","article-title":"Multiple myeloma presenting with a solitary cranial tumor with subdural extension: a case report","volume":"21","author":"Tabuchi","year":"1993","unstructured":"Tabuchi STakenobu AKohaya NMultiple myeloma presenting with a solitary cranial tumor with subdural extension: a case report. Article in Japanese. No Shinkei Geka. 1993;21(7):649-653."},{"key":"bib11","series-title":"World Neurosurg","first-page":"73","article-title":"Subdural hematoma mimickers: a systematic review","volume":"93","author":"Catana","year":"2016","unstructured":"Catana DKoziarz ACenic ASubdural hematoma mimickers: a systematic review. World Neurosurg. 2016;93:73-80."},{"issue":"7","key":"bib12","series-title":"Haematologica","first-page":"1780","article-title":"Multiple myeloma with central nervous system relapse","volume":"105","author":"Egan","year":"2020","unstructured":"Egan PAElder PTDeighan WIO\u2019Connor SJMAlexander HD.Multiple myeloma with central nervous system relapse. Haematologica. 2020;105(7):1780-1790."},{"issue":"10","key":"bib13","series-title":"Am J Hematol","first-page":"1897","article-title":"Central nervous system multiple myeloma: a real-world multi-institutional study of the Greek myeloma study group","volume":"99","author":"Katodritou","year":"2024","unstructured":"Katodritou EDalampira DDelimpasi SCentral nervous system multiple myeloma: a real-world multi-institutional study of the Greek myeloma study group. Am J Hematol. 2024;99(10):1897-1905."},{"issue":"3","key":"bib14","series-title":"Br J Haematol","first-page":"371","article-title":"Central nervous system multiple myeloma\u2014potential roles for intrathecal therapy and measurement of cerebrospinal fluid light chains","volume":"162","author":"Lee","year":"2013","unstructured":"Lee DKalff ALow MCentral nervous system multiple myeloma\u2014potential roles for intrathecal therapy and measurement of cerebrospinal fluid light chains. Br J Haematol. 2013;162(3):371-375."},{"issue":"4","key":"bib15","series-title":"Br J Haematol","first-page":"483","article-title":"Central nervous system involvement with multiple myeloma: long term survival can be achieved with radiation, intrathecal chemotherapy, and immunomodulatory agents","volume":"162","author":"Chen","year":"2013","unstructured":"Chen CIMasih-Khan EJiang HCentral nervous system involvement with multiple myeloma: long term survival can be achieved with radiation, intrathecal chemotherapy, and immunomodulatory agents. Br J Haematol. 2013;162(4):483-488."},{"issue":"2","key":"bib16","series-title":"Br J Haematol","first-page":"217","article-title":"A nationwide survey on central nervous system multiple myeloma in Japan: analysis of prognostic and treatment factors that impact survival","volume":"195","author":"Yamashita","year":"2021","unstructured":"Yamashita TTakamatsu HKawamura KA nationwide survey on central nervous system multiple myeloma in Japan: analysis of prognostic and treatment factors that impact survival. Br J Haematol. 2021;195(2):217-229."},{"issue":"3","key":"bib17","series-title":"Br J Haematol","first-page":"280","article-title":"Multiple myeloma involving central nervous system: high frequency of chromosome 17p13.1 (p53) deletions","volume":"127","author":"Chang","year":"2004","unstructured":"Chang HSloan SLi DKeith Stewart A.Multiple myeloma involving central nervous system: high frequency of chromosome 17p13.1 (p53) deletions. Br J Haematol. 2004;127(3):280-284."},{"issue":"4","key":"bib18","series-title":"Br J Haematol","first-page":"539","article-title":"The absence of CD56 on malignant plasma cells in the cerebrospinal fluid is the hallmark of multiple myeloma involving central nervous system","volume":"129","author":"Chang","year":"2005","unstructured":"Chang HBartlett ESPatterson BChen CIYi QL.The absence of CD56 on malignant plasma cells in the cerebrospinal fluid is the hallmark of multiple myeloma involving central nervous system. Br J Haematol. 2005;129(4):539-541."},{"issue":"4","key":"bib19","series-title":"Hematol Oncol","first-page":"170","article-title":"Emergence of central nervous system myeloma in the era of novel agents","volume":"30","author":"Gangatharan","year":"2012","unstructured":"Gangatharan SACarney DAPrince HMEmergence of central nervous system myeloma in the era of novel agents. Hematol Oncol. 2012;30(4):170-174."},{"issue":"6","key":"bib20","series-title":"Leukemia","first-page":"906","article-title":"Incidence of extramedullary disease in patients with multiple myeloma in the era of novel therapy, and the activity of pomalidomide on extramedullary myeloma","volume":"25","author":"Short","year":"2011","unstructured":"Short KDRajkumar SVLarson DIncidence of extramedullary disease in patients with multiple myeloma in the era of novel therapy, and the activity of pomalidomide on extramedullary myeloma. Leukemia. 2011;25(6):906-908."},{"issue":"12","key":"bib21","series-title":"Ann Hematol","first-page":"2033","article-title":"Lack of survival improvement with novel anti-myeloma agents for patients with multiple myeloma and central nervous system involvement: the Greek myeloma study group experience","volume":"94","author":"Katodritou","year":"2015","unstructured":"Katodritou ETerpos EKastritis ELack of survival improvement with novel anti-myeloma agents for patients with multiple myeloma and central nervous system involvement: the Greek myeloma study group experience. Ann Hematol. 2015;94(12):2033-2042."},{"issue":"10","key":"bib1","series-title":"Neuroradiology","first-page":"735","volume":"42","author":"De Blay","year":"2000","unstructured":"De Blay VMisson NDardenne GDupuis MJM.Leptomeningeal myelomatosis mimicking a subdural haematoma. Neuroradiology. 2000;42(10):735-737."},{"issue":"4","key":"bib2","series-title":"Am J Hematol","first-page":"228","article-title":"Cerebral and meningeal multiple myeloma after autologous stem cell transplantation. A case report and review of the literature","volume":"62","author":"Petersen","year":"1999","unstructured":"Petersen SLWagner AGimsing P.Cerebral and meningeal multiple myeloma after autologous stem cell transplantation. A case report and review of the literature. Am J Hematol. 1999;62(4):228-233."},{"issue":"1","key":"bib3","series-title":"J Clin Neurosci","first-page":"122","article-title":"Intracranial multiple myeloma involving the dura","volume":"13","author":"Tsang","year":"2006","unstructured":"Tsang CSHo LCTan TC.Intracranial multiple myeloma involving the dura. J Clin Neurosci. 2006;13(1):122-123."},{"issue":"3","key":"bib4","series-title":"Neurol Neurochir Pol","first-page":"252","article-title":"Intracranial multiple myeloma may imitate subdural hemorrhage: how to overcome diagnostic limitations and avoid errors in treatment","volume":"51","author":"Prajsnar-Borak","year":"2017","unstructured":"Prajsnar-Borak ABalak NVon Pein HGlaser MBoor SStadie A.Intracranial multiple myeloma may imitate subdural hemorrhage: how to overcome diagnostic limitations and avoid errors in treatment. Neurol Neurochir Pol. 2017;51(3):252-258."},{"key":"bib5","series-title":"World Neurosurg","first-page":"247","article-title":"IgG4-related disease in the frontal convexity concomitant with smoldering multiple myeloma: a case report and review of the literature regarding therapeutic implications","volume":"143","author":"Tanaka","year":"2020","unstructured":"Tanaka TFuga MTeshigawara AIgG4-related disease in the frontal convexity concomitant with smoldering multiple myeloma: a case report and review of the literature regarding therapeutic implications. World Neurosurg. 2020;143:247-260."},{"issue":"6","key":"bib6","series-title":"Am J Hematol","first-page":"575","article-title":"Central nervous system involvement by multiple myeloma: a multi-institutional retrospective study of 172 patients in daily clinical practice","volume":"91","author":"Jurczyszyn","year":"2016","unstructured":"Jurczyszyn AGrzasko NGozzetti ACentral nervous system involvement by multiple myeloma: a multi-institutional retrospective study of 172 patients in daily clinical practice. Am J Hematol. 2016;91(6):575-580."},{"issue":"22","key":"bib7","series-title":"Blood","first-page":"2401","article-title":"Efficacy of venetoclax as targeted therapy for relapsed\/refractory t(11;14) multiple myeloma","volume":"130","author":"Kumar","year":"2017","unstructured":"Kumar SKaufman JLGasparetto CEfficacy of venetoclax as targeted therapy for relapsed\/refractory t(11;14) multiple myeloma. Blood. 2017;130(22):2401-2409."},{"issue":"7","key":"bib8","series-title":"J Cancer","first-page":"1151","article-title":"Venetoclax penetrates the blood brain barrier: a pharmacokinetic analysis in pediatric leukemia patients","volume":"14","author":"Badawi","year":"2023","unstructured":"Badawi MMenon RPlace AEVenetoclax penetrates the blood brain barrier: a pharmacokinetic analysis in pediatric leukemia patients. J Cancer. 2023;14(7):1151-1156."},{"key":"bib9","series-title":"Onco Targets Ther","first-page":"3373","article-title":"Multiple myeloma with dural mater involvement","volume":"12","author":"Liu","year":"2019","unstructured":"Liu SLi XLi YLi DWang YTian C.Multiple myeloma with dural mater involvement. Onco Targets Ther. 2019;12:3373-3375."},{"issue":"7","key":"bib10","series-title":"No Shinkei Geka","first-page":"649","article-title":"Multiple myeloma presenting with a solitary cranial tumor with subdural extension: a case report","volume":"21","author":"Tabuchi","year":"1993","unstructured":"Tabuchi STakenobu AKohaya NMultiple myeloma presenting with a solitary cranial tumor with subdural extension: a case report. Article in Japanese. No Shinkei Geka. 1993;21(7):649-653."},{"key":"bib11","series-title":"World Neurosurg","first-page":"73","article-title":"Subdural hematoma mimickers: a systematic review","volume":"93","author":"Catana","year":"2016","unstructured":"Catana DKoziarz ACenic ASubdural hematoma mimickers: a systematic review. World Neurosurg. 2016;93:73-80."},{"issue":"7","key":"bib12","series-title":"Haematologica","first-page":"1780","article-title":"Multiple myeloma with central nervous system relapse","volume":"105","author":"Egan","year":"2020","unstructured":"Egan PAElder PTDeighan WIO\u2019Connor SJMAlexander HD.Multiple myeloma with central nervous system relapse. Haematologica. 2020;105(7):1780-1790."},{"issue":"10","key":"bib13","series-title":"Am J Hematol","first-page":"1897","article-title":"Central nervous system multiple myeloma: a real-world multi-institutional study of the Greek myeloma study group","volume":"99","author":"Katodritou","year":"2024","unstructured":"Katodritou EDalampira DDelimpasi SCentral nervous system multiple myeloma: a real-world multi-institutional study of the Greek myeloma study group. Am J Hematol. 2024;99(10):1897-1905."},{"issue":"3","key":"bib14","series-title":"Br J Haematol","first-page":"371","article-title":"Central nervous system multiple myeloma\u2014potential roles for intrathecal therapy and measurement of cerebrospinal fluid light chains","volume":"162","author":"Lee","year":"2013","unstructured":"Lee DKalff ALow MCentral nervous system multiple myeloma\u2014potential roles for intrathecal therapy and measurement of cerebrospinal fluid light chains. Br J Haematol. 2013;162(3):371-375."},{"issue":"4","key":"bib15","series-title":"Br J Haematol","first-page":"483","article-title":"Central nervous system involvement with multiple myeloma: long term survival can be achieved with radiation, intrathecal chemotherapy, and immunomodulatory agents","volume":"162","author":"Chen","year":"2013","unstructured":"Chen CIMasih-Khan EJiang HCentral nervous system involvement with multiple myeloma: long term survival can be achieved with radiation, intrathecal chemotherapy, and immunomodulatory agents. Br J Haematol. 2013;162(4):483-488."},{"issue":"2","key":"bib16","series-title":"Br J Haematol","first-page":"217","article-title":"A nationwide survey on central nervous system multiple myeloma in Japan: analysis of prognostic and treatment factors that impact survival","volume":"195","author":"Yamashita","year":"2021","unstructured":"Yamashita TTakamatsu HKawamura KA nationwide survey on central nervous system multiple myeloma in Japan: analysis of prognostic and treatment factors that impact survival. Br J Haematol. 2021;195(2):217-229."},{"issue":"3","key":"bib17","series-title":"Br J Haematol","first-page":"280","article-title":"Multiple myeloma involving central nervous system: high frequency of chromosome 17p13.1 (p53) deletions","volume":"127","author":"Chang","year":"2004","unstructured":"Chang HSloan SLi DKeith Stewart A.Multiple myeloma involving central nervous system: high frequency of chromosome 17p13.1 (p53) deletions. Br J Haematol. 2004;127(3):280-284."},{"issue":"4","key":"bib18","series-title":"Br J Haematol","first-page":"539","article-title":"The absence of CD56 on malignant plasma cells in the cerebrospinal fluid is the hallmark of multiple myeloma involving central nervous system","volume":"129","author":"Chang","year":"2005","unstructured":"Chang HBartlett ESPatterson BChen CIYi QL.The absence of CD56 on malignant plasma cells in the cerebrospinal fluid is the hallmark of multiple myeloma involving central nervous system. Br J Haematol. 2005;129(4):539-541."},{"issue":"4","key":"bib19","series-title":"Hematol Oncol","first-page":"170","article-title":"Emergence of central nervous system myeloma in the era of novel agents","volume":"30","author":"Gangatharan","year":"2012","unstructured":"Gangatharan SACarney DAPrince HMEmergence of central nervous system myeloma in the era of novel agents. Hematol Oncol. 2012;30(4):170-174."},{"issue":"6","key":"bib20","series-title":"Leukemia","first-page":"906","article-title":"Incidence of extramedullary disease in patients with multiple myeloma in the era of novel therapy, and the activity of pomalidomide on extramedullary myeloma","volume":"25","author":"Short","year":"2011","unstructured":"Short KDRajkumar SVLarson DIncidence of extramedullary disease in patients with multiple myeloma in the era of novel therapy, and the activity of pomalidomide on extramedullary myeloma. Leukemia. 2011;25(6):906-908."},{"issue":"12","key":"bib21","series-title":"Ann Hematol","first-page":"2033","article-title":"Lack of survival improvement with novel anti-myeloma agents for patients with multiple myeloma and central nervous system involvement: the Greek myeloma study group experience","volume":"94","author":"Katodritou","year":"2015","unstructured":"Katodritou ETerpos EKastritis ELack of survival improvement with novel anti-myeloma agents for patients with multiple myeloma and central nervous system involvement: the Greek myeloma study group experience. Ann Hematol. 2015;94(12):2033-2042."}],"container-title":["Journal of Neurosurgery: Case Lessons"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/10\/6\/article-CASE25347.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/10\/6\/article-CASE25347.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/10\/6\/article-CASE25347.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T11:09:11Z","timestamp":1769684951000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/10\/6\/article-CASE25347.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,11]]},"references-count":42,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.3171\/case25347","relation":{},"ISSN":["2694-1902"],"issn-type":[{"value":"2694-1902","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,11]]}}}