title: [Infected and calcified chronic subdural hematoma presenting an attitude of acute hematoma on MRI: case report].
abstract: We report a case of calcified chronic subdural hematoma with unusual magnetic resonance imaging (MRI) findings. A 50-year-old male with no marked medical history presented with fever for two weeks. Computed tomography (CT) revealed a thick, calcified subdural hematoma of low-iso mixed density. MRI showed characteristic signals of hematoma in the acute stage. Total removal of the hematoma by craniotomy was performed after rapid deterioration of consciousness. At surgery, a muddy hematoma and a small amount of pus were seen within the calcified capsule. Diagnosis of infected and calcified chronic subdural hematoma was established. His symptoms were resolved completely within the following few months. As the mechanisms of delayed signal sequence of hematoma on MRI, we speculate existence of tissue hypoxia associated with infection and paramagnetic effects of free radicals and ions associated with inflammation, necrosis and calcification.
authors.affiliation: Department of Neurosurgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.
authors.forename: Kimitoshi
authors.initials: K
authors.lastname: Sato
authors.forename: Masaru
authors.initials: M
authors.lastname: Yamada
authors.forename: Satoru
authors.initials: S
authors.lastname: Shimzu
authors.forename: Satoshi
authors.initials: S
authors.lastname: Utsuki
authors.forename: Shingo
authors.initials: S
authors.lastname: Konno
authors.forename: Kiyotaka
authors.initials: K
authors.lastname: Fujii
authors.forename: Shinichi
authors.initials: S
authors.lastname: Kan
mesh_terms: D002114:Calcinosis; D003937:Diagnosis, Differential; D020199:Hematoma, Subdural, Acute / Q000175:diagnosis*; D020200:Hematoma, Subdural, Chronic / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D013203:Staphylococcal Infections / Q000150:complications