PMC3589848_01
Chronic calcified subdural hematoma of the frontoparietal right convexity, with calcified inner membrane, determining a significant midline shift, with uncal herniation. (a and b) axial CT scan, (c) Sagital T1 MRI, (d) axial DP MRI, (e) Coronal T2 MRI
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F1
The computed tomography (CT) scans and magnetic resonance imaging (MRI) documented a large subdural collection of the left hemisphere, with calcified inner membrane [Figure 1].
Intraoperative images. (a) Right fronto-parietal craniotomy, exposing the dura with the mould of the underlying calcified chronic subdural hematoma's capsule, (b) dissection of the inner surface of the dura from the underlying calcified capsule, (c) after opening the capsule, aspiration of the contents of the liquid content, with various stages of subacute organized hematoma, (d) the inner membrane, which was not adherent to parenchymal surface, allowing for its complete removal without injuring the underlying brain, (e) the lack of brain reexpansion after complete removal of the hematoma
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F2
Left frontoparietal craniotomy was performed [Figure 2], exposing an "armored dura", with the mould of the underlying hematoma.
Postoperative CT scan at 90 days, showing reexpansion, without any residual subdural collection
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F3
His postoperative CT scans documented progressive reexpansion of the brain and resolution of subdural collection [Figure 3].