A post-traumatic ossified subdural chronic hematoma successfully managed in a 34-year-old woman: a case report

Ossified or calcified subdural chronic hematoma is an uncommon condition with an incidence of 0.3–2% of all chronic subdural hematomas. It can cause significant mortality and morbidity, especially in young patients. Because of the rare incidence of this condition, its pathophysiology and management preferences have not yet been clearly established, which raises the importance of reporting such cases in order to add valuable databases to the literature. CASE PRESENTATION: A 34-year-old woman with a history of head trauma several years ago presented with refractory headaches, convulsions, and muscle weakness. Computed tomography showed an extra-axial calcified lesion in the frontal lobe. Surgical treatment was decided considering the patient’s age, in addition to the presence of serious medically uncontrolled symptoms. The calcified lesion was successfully removed surgically, and the patient recovered completely. Pathological examination confirmed the diagnosis of ossified subdural chronic hematoma. CLINICAL DISCUSSION: The symptoms of ossified subdural hematomas are not specific. However, the presence of a history of head trauma should raise suspicion of this condition. Computerized tomography is usually used as the diagnostic method. Nevertheless, it is unable to differentiate ossified chronic subdural hematomas from other intracranial extra-axial calcified lesions that need to be considered as a differential diagnosis. Pathologic investigations are needed to provide the final diagnosis. CONCLUSIONS: We highly recommend surgical therapy for ossified subdural hematomas that are symptomatic and persistent, especially in young patients. We further stress the significance of postsurgical anticonvulsant prophylaxis, particularly in patients presenting convulsions.