A relatively rare condition of ossified chronic subdural hematoma (SDH) mimicking cerebral stroke is presented. A 67-year-old man presented with headache, dysphasia, and left-sided hemiparesis. Routine skull x-ray showed a huge calcification extending from the frontal to the parietal regions in the right side. CT and MRI scan revealed a huge ossified SDH covering the right hemisphere. Right frontoparietal craniotomy was performed and the ossified SDH was completely removed. Severe adhesion was noticed between the pia mater and the inner surface of the ossified mass. The subdural mass had ossified hard outer and inner rims and a soft central part. The postoperative course was uneventful and 3 months after the operation, the patient was neurologically intact. The authors report the successful treatment of a patient with a huge ossified SDH covering the right hemisphere. Careful dissection and total removal are needed in such symptomatic cases to avoid cortical injury and to improve results.
Aged ; Hematoma, Subdural, Chronic/diagnosis/pathology/*surgery ; Human ; Magnetic Resonance Imaging ; Male ; Ossification, Heterotopic/diagnosis/pathology/*surgery ; Tomography, X-Ray Computed

A 26-year-old male presented with a 6-day history of paroxysmal headache which was worsen with nausea and vomiting for 1 day. Head CT on admission revealed left chronic subdural hematoma with midline shift. An emergency Burr hole drainage for hematoma was performed. Headache recurred 6 days later. MRI of the brain revealed a diffuse thickening and a gadolinium-enhancement of the falx, cranial dura mater and tentorium cerebelli on the left side with pia mater involved. Lumber puncture showed increased intracranial pressure and elevated IgG level in cerebrospinal fluid. Histological examination of the biopsy specimen showed thickened, fibrotic dura with a sterile chronic inflammation. According to pathological examination, idiopathic hypertrophic cranial pachymeningitis was considered as the final diagnosis. Symptoms were improved with steroid pulse therapy.
Adult ; Biopsy ; Brain ; pathology ; Drainage ; Dura Mater ; pathology ; Hematoma, Subdural, Chronic ; etiology ; surgery ; Humans ; Hypertrophy ; diagnosis ; Immunoglobulin G ; cerebrospinal fluid ; Intracranial Hypertension ; etiology ; Magnetic Resonance Imaging ; Male ; Meningitis ; diagnosis ; Steroids ; administration & dosage ; therapeutic use ; Tomography, X-Ray Computed