Calcified chronic subdural hematoma: illustrative case.

Area of Science:

• Neurosurgery
• Neurology
• Radiology

Background:

• Calcified chronic subdural hematomas (CCSDHs) represent a rare subtype of chronic subdural hematomas (CSDHs), accounting for only 0.3-2.7% of cases.
• While surgical outcomes for CSDHs are generally favorable, the efficacy of surgery for the calcified variant (CCSDHs) remains less established.

Observation:

• A 75-year-old male presented with progressive left limb motor dysfunction over 18 months and acute altered sensorium.
• Preoperative aspiration led to postoperative pulmonary compromise, evidenced by chest radiography.
• CT and MRI revealed a large, calcified subdural collection in the right frontal and parietal regions.

Findings:

• Surgical excision of the calcified subdural hematoma was successfully completed.
• The patient's neurological deterioration and presentation necessitated surgical intervention.
• MRI also identified thalamic lacunar infarcts, potentially related to the calcified hematoma.

Implications:

• This case underscores that surgical intervention can be a crucial treatment option for CCSDHs presenting with significant neurological deficits.
• The findings suggest a possible association between calcified subdural hematomas and secondary ischemic changes, such as lacunar infarcts.