Calcified chronic subdural hematoma

Case contributed by Craig Hacking
Diagnosis certain

Presentation

Follow up. VP shunt.

Patient Data

Age: 45 years
Gender: Female

The right transparietal VP shunt is unchanged from the most recent neuroimaging with the tip abutting the septum pellucidum. No shunt fracture or disruption. Stable position of the disconnected segment of shunt tubing within the body and anterior horn of the right lateral ventricle. Mild dilation of the occipital horn of the right lateral ventricle is longstanding. No hydrocephalus. No periventricular hypoattenuation.

No intracranial hemorrhage. Grey-white matter differentiation is preserved. No suspicious osseous lesion. Stable extra-axial ossification overlying both cerebral convexities. Unchanged mild mass effect on the underlying cortical sulci. The paranasal sinuses and mastoid air cells are aerated.

Case Discussion

Chronic SDHs may calcify, seen more commonly in children and young adults than the elderly. They typically demonstrate capsular (peripheral) calcification whereas the center of the hematoma remains liquid or gelatinous.

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