Calcified chronic subdural hematoma: A rare cause of epilepsy - Case report
Elizabeth Ubald Wampembe1, Jay Lodhia1, Lele Mutombo Fabrice2
1General Surgery, Kilimanjaro Christian Medical Centre, Moshi, Tanzania; Kilimanjaro Christian Medical University College, Moshi, Tanzania.
Insights
Surgical removal of calcified chronic subdural hematoma (CCSDH) effectively treated a patient with intractable epilepsy. This intervention improved neurological function and seizure control, highlighting surgery as a key treatment for symptomatic CCSDH.
Area of Science:
- Neurosurgery
- Neurology
- Radiology
Background:
- Chronic subdural hematoma (CSDH) is a common neurosurgical condition, particularly in the elderly.
- A rare variant, calcified chronic subdural hematoma (CCSDH), occurs more frequently in children and young adults.
- CSDH can develop without recalled injury, especially in individuals with epilepsy.
Observation:
- A 49-year-old male with a 23-year history of poorly controlled epilepsy presented with increased seizures.
- The patient had a likely undiagnosed chronic subdural hematoma that calcified over time.
- Symptoms included poorly controlled seizures despite medication.
Findings:
- Surgical intervention involving craniotomy and removal of the calcified hematoma led to significant symptom improvement.
- Postoperative recovery showed restored neurological function.
- Calcified subdural hematoma is a rare cause of epilepsy.
Implications:
- Surgical treatment is crucial for symptomatic CCSDH, especially in young patients or those with progressive neurological deficits.
- Successful surgical outcomes underscore the efficacy of intervention for this uncommon condition.
- Considering CCSDH in patients with refractory epilepsy is important for diagnosis and management.
Introduction And Importance:
Chronic subdural hematoma (CSDH) is a common neurosurgical condition, particularly in the elderly. A rare variant, calcified chronic subdural hematoma, occurs more frequently in children and young adults. The calcification mechanism involves poor circulation, absorption issues, intravascular thrombosis, and prolonged hematoma existence. Clinical symptoms resemble non calcified CSDH. Surgery is generally recommended, especially for infants, young patients, or those with progressive neurological deficit. Calcified subdural hematoma is a rare cause of epilepsy.
Case Presentation:
Rare case of a 49-year-old male with chronic calcified subdural hematoma (CCSDH) and increased seizures. Despite a history of epilepsy, his symptoms were poorly controlled with medication. Surgical intervention, involving craniotomy and careful removal of the calcified hematoma, led to significant improvement in symptoms and restored neurological function.
Clinical Discussion:
Subdural hematoma (SDH) is a blood collection between the arachnoid and dura membranes, often following minor head trauma. Chronic subdural hematoma (CSDH) can occur without recalled injury, especially in individuals with conditions like epilepsy. Our patient, with a 23-year history of poorly controlled seizures, likely had undiagnosed CSDH that calcified over time. Calcified chronic subdural hematoma (CCSDH) is typically due to regressive changes and often requires surgical intervention in young or symptomatic patients to prevent further brain damage. Our patient's postoperative recovery highlights the effectiveness of surgery for symptomatic CCSDH.
Conclusion:
The case highlights the importance of considering surgical treatment for symptomatic CCSDH, especially in cases with clinical deterioration. The successful outcome aligns with existing literature, emphasizing the efficacy of surgical intervention for this uncommon condition.
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