1. Department of Neurosurgery, Affiliated Hospital of Qinghai University, Xining 810000, China; 2. Department of Neurology, Qinghai People's Provincial Hospital, Xining 810000, China
Calcified chronic subdural hematoma: A case report and literature review
1. Department of Neurosurgery, Affiliated Hospital of Qinghai University, Xining 810000, China; 2. Department of Neurology, Qinghai People's Provincial Hospital, Xining 810000, China
摘要 Calcified chronic subdural hematoma (CCSDH) is a rare disease that accounts for approximately 0.3%-2.7% of all chronic subdural hematomas (CSDHs). The clinical features of CCSDH are very similar to those of noncalcified CSDH and include headache, decreased alertness, weakness, numbness, gait disturbance, seizures, memory impairment, confusion, and unconsciousness. All symptomatic CCSDH should be treated surgically. Majority of these patients recover well following surgery. In this report, we present the case of a patient with CCSDH who developed severe cerebral edema following its removal, necessitating decompressive craniectomy. Although there were no abnormal findings in laboratory blood tests, and no signs of brain herniation or epilepsy was found the following day after surgery, the patient's family refused all treatment and a post-operative brain computed tomography (CT) scan. The patient was discharged and died at home. Cerebral hematoma and normal perfusion pressure breakthrough (NPPB) may cause severe cerebral edema following the total removal l of a CCSDH.
Abstract: Calcified chronic subdural hematoma (CCSDH) is a rare disease that accounts for approximately 0.3%-2.7% of all chronic subdural hematomas (CSDHs). The clinical features of CCSDH are very similar to those of noncalcified CSDH and include headache, decreased alertness, weakness, numbness, gait disturbance, seizures, memory impairment, confusion, and unconsciousness. All symptomatic CCSDH should be treated surgically. Majority of these patients recover well following surgery. In this report, we present the case of a patient with CCSDH who developed severe cerebral edema following its removal, necessitating decompressive craniectomy. Although there were no abnormal findings in laboratory blood tests, and no signs of brain herniation or epilepsy was found the following day after surgery, the patient's family refused all treatment and a post-operative brain computed tomography (CT) scan. The patient was discharged and died at home. Cerebral hematoma and normal perfusion pressure breakthrough (NPPB) may cause severe cerebral edema following the total removal l of a CCSDH.
20180119184447 Figure 1 Pre-operative CT of the brain showing a large, mixeddensity lesion with a hyperdense calcified rim in the right frontotemporo-parietal region (a–c). Pre-operative bone window CT of the brain showing that the inner part of the lesion was calcified and parts of the skull had become thinner (d–f).
20180119184505 Figure 2 Intra-operative photographs. (a) After the bone flap was removed, a meningioma-like mass was revealed. (b) A dark brown muddy hematoma was revealed in the lesion. (c) The inner membrane of the lesion was hard and calcified. (d) Severe cerebral edema following the hematoma resection.
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2017, Vol. 3 
