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무증상 양측성 석회화 된 만성경막하혈종

A Case of Asymptomatic Bilateral Calcified Chronic Subdural Hematoma

Article information

J Korean Neurol Assoc. 2019;37(2):214-215
Publication date (electronic) : May 1, 2019
doi : http://dx.doi.org/10.17340/jkna.2019.2.22
Yun-Ju Choi, MD
Department of Neurology, Presbyterian Medical Center, Jeonju, Korea
최윤주
예수병원 신경과
Address for correspondence: Yun-Ju Choi, MD Department of Neurology, Presbyterian Medical Center, 365 Seowon-ro, Wansan-gu, Jeonju 54987, Korea Tel: +82-63-230-1570 Fax: +82-63-230-1499 E-mail: neurologist16@gmail.com
received : March 4, 2019 , rev-recd : March 12, 2019 , accepted : March 12, 2019 .

50세 남자가 최근 한 달 전부터 가끔씩 발생하는 두통으로 내원하였다. 두통은 긴장형두통 양상으로 35년 전 두개내 출혈의 과거력이 있어 두부 컴퓨터단층촬영을 시행하였고, 양측에 거대한 석회화를 동반한 병변과 이로 인한 뇌의 위축이 보였으며 뇌 자기공명영상를 통해 석회화된 만성경막하혈종으로 진단하였다(Fig.). 이는 만성경막하혈종의 0.3-2.7%에서만 나타날 정도로 매우 드문 후유증으로, 임상 증상은 정신지체, 치매, 국소 신경계 징후 등 다양하게 나타나는 것으로 알려져 있지만 본 증례와 같이 드물게 증상이 없을 수도 있다[1]. 증례에 따라 수술을 하는 경우도 있으나 본 증례의 경우는 일반 진통제에 반응이 좋아 수술을 하지 않았다[2].

Figure.

Brain computed tomography shown multiple extra-axial crescent-shaped or bi-convex-shaped hypodense mass like lesions with thick hyperdense calcific margins (A). Brain magnetic resonance images (MRI) shown huge hyperintense lesions to cerebrospinal fluid (CSF), with hypointense capsule to CSF on T1 images (B). On T2 images shown the lesions that isointense to CSF with hypointense capsule (C). The lesions were hyperintense and the capsule was hypointense compare with CSF intensity on fluid attenuated invention recovery images (D). Susceptibility weighted images shown markedly hypointense periphery (E).

References

1. Pappamikail L, Rato R, Novais G, Bernardo E. Chronic calcified subdural hematoma: case report and review of the literature. Surg Neurol Int 2013;4:21.
2. Rahman A, Haque M, Bhandari PB. Calcified chronic subdural haematoma. BMJ Case Rep 2012;201212bcr0120125499.

Article information Continued

Copyright © 2019 Korean Neurological Association

Figure.

Figure.

Brain computed tomography shown multiple extra-axial crescent-shaped or bi-convex-shaped hypodense mass like lesions with thick hyperdense calcific margins (A). Brain magnetic resonance images (MRI) shown huge hyperintense lesions to cerebrospinal fluid (CSF), with hypointense capsule to CSF on T1 images (B). On T2 images shown the lesions that isointense to CSF with hypointense capsule (C). The lesions were hyperintense and the capsule was hypointense compare with CSF intensity on fluid attenuated invention recovery images (D). Susceptibility weighted images shown markedly hypointense periphery (E).