An early presentation of a large calcified chronic subdural hematoma presenting as an inner eggshell in an elderly patient: A case report

Abstract

Introduction: Calcified chronic subdural hematoma which is usually found in children and takes several months for calcification to be seen on imaging is presented in an elderly patient in which the calcification could be visible early after trauma.

Presentation of case: An elderly man, 83, living with caregiver, was brought to our hospital due to dysarthria and suffocation for 2 days. Three months ago, he experienced his head injury from a fall. Four days ago, he developed progressive left hemiparesis. Because of clinically progressive deterioration and computed tomography scan revealing acute epidural hematoma, the patient was transferred to operating room. Gross findings and pathologic reports unfolded that the lesion was consistent with calcified chronic subdural hematoma. Despite a successful operation, the patient cannot survive.

Discussion: In addition to the presentation in an elderly patient, there was scarcely any paper reporting an early presentation of calcium deposition. Nevertheless, according to the lack of previous data recorded for his earlier performance, deviation on walking or sitting, before the accident, we cannot actually know whether there has been calcium deposition in his brain before or not.

Conclusion: Calcified chronic subdural hematoma could present in elderly group of patient and early presentation of calcium deposition following trauma is possible. However, surgery in this group of patient entails a risk of fatality, despite the successful operation.

Keywords: Calcified; Hemiparesis; Subdural hematoma.