Computed tomography of the "armored brain".

Area of Science:

• Neurology
• Neurosurgery
• Radiology

Background:

• Chronic subdural hematomas (CSDH) are collections of blood that can develop slowly over weeks or months.
• Calcification within a CSDH is a rare finding, leading to significant mass effect and potential complications.

Observation:

• The term "armored brain" describes extensive calcification of a CSDH encasing the cerebral hemispheres.
• Computed tomography (CT) imaging is crucial for visualizing the extent and characteristics of calcified CSDH.
• Five cases of calcified CSDH were analyzed using CT scans.

Findings:

• Calcified CSDH can present with varied neurological symptoms depending on the degree of brain compression.
• The pathogenesis involves chronic inflammation and organization of the subdural collection, leading to ossification and calcification.
• Treatment strategies depend on clinical presentation and may include surgical evacuation.

Implications:

• Understanding the "armored brain" phenomenon is vital for accurate diagnosis and management of complex CSDH cases.
• CT findings guide therapeutic decisions, balancing risks and benefits of surgical intervention.
• Further research into the specific mechanisms of calcification in CSDH could inform novel treatment approaches.