PMC5133471_01
Magnetic resonance imaging (MRI) findings. Axial fluid-attenuated inversion recovery (FLAIR) (A) and gadolinium (Gd)-enhanced T1-weighted (B) MR images showing slight retention of the subdural hematoma. The hematoma is not enhanced on the administration of Gd.
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Intracranial magnetic resonance imaging (MRI) demonstrated almost normal findings, except for slight retention of the subdural hematoma without gadolinium (Gd) enhancement (Fig. 1).
Cervical computed tomography (CT) scans around the odontoid process. Sagittal reconstruction showing the linear calcification at the posterior side of the dens suggesting calcium pyrophosphate dehydrate (CPPD) (white arrow) (A). The axial image demonstrates the right-dominant, half-ringed form of calcification at the posterolateral side of the dens (white arrowhead) (B).
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However, a plain cervical computed tomography (CT) scan and three-dimensional (3D)-reconstruction imaging detected a remarkable crown-like calcification surrounding the odontoid process (Fig. 2).
Sagittal T2-weighted MR imaging with fat suppression reveals a non-invasive, mass-like lesion around the odontoid process, but the soft tissue surrounding the dense is hyperintense (white arrow) (A-H; from the right side to the left side).
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In addition, cervical MRI did not demonstrate strong direct compression of the cervical cord; however, the soft tissue surrounding the odontoid process was hyperintense on T2-weighted imaging with fat suppression without Gd enhancement (Fig. 3).
X-ray and CT scan showing that calcium deposits are apparent in the right knee (white arrow and white arrowhead).
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Although clinically asymptomatic without a previous history of arthritis, the patient's X-ray and CT of the knee joints revealed calcium deposits, suggesting underlying crystalline deposition disease (Fig. 4).
Sagittal T2-weighted MR imaging with fat suppression demonstrates that the T2-hyperintense lesion on preoperative MRI has disappeared 2 weeks after oral administration of non-steroidal anti-inflammatory drugs (A-H; from the right side to the left side).
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T2 hyperintense lesion on MRI disappeared within 2 weeks (Fig. 5), which helped us exclude infectious meningitis and sepsis from the differential diagnosis. The symptoms improved completely, and the patient was discharged 15 days after admission.