Abstract
Various clinical and radiologic presentations of chronic subdural hematoma (SDH) are
reported in the literature. Therefore, sometimes the presentation of a patient with
chronic SDH often creates confusion regarding decision making. Here, the authors present
three cases of chronic SDH, in which the clinical presentation, radiology, and operative
findings were unusual. In the first case, the patient presented with acute extradural
hematoma like clinical as well as radiologic presentation but intraoperatively found
to have chronic calcified SDH, whereas another case with history of bilateral ventriculoperitoneal
(VP) shunting at childhood presented with large head with discharging sinus at the
forehead. Radiologic and operative findings were very much unusual. Intraoperatively,
the bilateral subdural collection was found to have fungus-like projections with subdural
space communicating with the forehead sinus. In another case, a 10-year-old girl with
history of VP shunting at age of 6 months presented with left hemiparesis of subacute
onset. Computed tomographic (CT) scan revealed biconvex lesion at the right parietal
region intraoperatively. The authors found the shell-like lesion with inner and outer
membrane calcified, within which the subdural collection was present. In these three
cases, they observed the very unusual mode of presentation of chronic SDH, and in
the literature such mode of presentation and operative findings of such type are very
rare.
Keywords
chronic subdural hematoma - chronic calcified subdural hematoma - third nerve palsy
- chronic subdural hematoma with fungus-like mass
