Iatrogenic Chronic Calcified/Ossified Epidural Hematoma: Case Report

Abstract

Chronic calcified/ossified epidural hematomas are rare complications of head trauma or cranial procedures. A case of iatrogenic chronic calcified/ossified epidural hematoma is presented here to discuss its causes and emphasize the importance of appropriate dural closure. A 3-year- old girl was admitted to our clinic with an initial diagnosis of huge cystic craniopharyngioma. Ten months after operative resection chronic calcified/ossified epidural hematoma was detected in control MRI’s. She was reoperated and the encapsulated hematoma was evacuated. The ossified tissue and the recurrent tumor were excised in the same operation. Primary causes of chronic epidural hematomas are detachment of dura from inner calvarial surface as a result of trauma or surgery and venous bleeding from the dura and the bone. Additionally, decrease in local tissue pressure makes it easier for blood to accumulate in the epidural space. Regressive changes or repair processes may cause the hematoma to be a calcified/ossified lesion. Inappropriately performed dural closures may cause chronic ossified/calcified epidural hematomas. These hematomas should be evacuated in order to prevent future complications.