Calcified chronic subdural hematoma: A rare cause of epilepsy - Case report

Abstract

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.

Keywords: Chronic; Craniotomy; Epilepsy; Hematoma; Subdural; Trauma.