Same side double chronic calcified epidural hematoma: case report and review of literature

The efficacy of conservative treatment of an epidural hematoma is unconvinced in children. Here we describe an 18-year-old boy who had been followed up conservatively for 20 days after injury at a local hospital, with an acute same sided double epidural hematoma. The patient presented to us after three weeks of injury, with symptoms of elevated intracranial pressure. A new CT scan of head done at this time revealed lack of resolution of the former hematoma accompanied by a thick hyperdense layer in close proximity to the dural layer. An immediate craniotomy was performed to evacuate the hematoma. The ossified layer, which was densely adhered to the dura mater, was also completely removed. Both the occurrence of same side double epidural hematoma and rapid ossification and/or calcification of an epidural hematoma after a head injury have rarely been reported previously. Possible mechanisms of occurrence of same side double epidural hematoma and its rapid ossification are also discussed in relation to the present report, and the relevant literature is reviewed.