Calcification of Chronic Subdural Hematoma in a Child: Case Report

Ryu, Youn Seok; Cho, Kyung Uk; Kim, Soon Kie; Moon, Myong Sun

Abstract

Intracranial calcification is relatively common, but calcification of chronic subdural hematoma is rare condition. Nevertheless, already in 1884 Von Rokitansky had described a calcified chronic subdural hematoma found at autopsy. Subsequently Lewis(1889), Elsner(1896), and O'sullivan(1925) mentioned calcification of intracranial hematoma. In 1930, Goldham reported the first case treated by operation. A 15-year-old Korean male was admitted to this hospital because of a episode of generalized epileptic seizure, one day before admission. Past history was unknown about head injury and his past birth condition. Patient has complained weakness of right upper and lower extremely since his infant. Neurological examination revealed the left hemiparesis, but others were normal. Skull X-ray films showed dense conglomerated calcific density with surrounding rim like lucency in left fronto-parietal region. Left carotid angiogram revealed no abnormalities except hypoplasia of left hemisphere. Brain computed tomogram demonstrated hyperdense subdural mass surrounding decreased parenchymal density in left fronto-parietal region. A craniectomy was performed for removal of the calcified mass. A oval concaved bony hard mass was found in subdural space. The calcified bony hard mass was adherent with the surface of cortex by loose sonnective tissue. We removed the bony hard mass completely. The postoperative course was very satisfactory and seizure has not been appeared after discharge. Microscopic findings demonstrated ossification and fibrosis, consisting with old hematoma which showed up a calcification of chronic subdural hematoma.