Presentation
Headache. History of a car accident 20 years ago.
Patient Data
Left frontal parasagittal intra-axial heterogeneous lesion with hypointense signal in all sequences. It is surrounded by mild gliosis.
Left frontal completely calcified parasagittal intra-axial lesion surrounded by mild gliosis. The medial aspect of the lesion is abutting the falx.
Case Discussion
The patient gave a history of a car accident 20 years ago and claimed that he was diagnosed with left intracerebral hematoma. Dependent on the given history, the calcified intracerebral lesion is suggestive of a calcified hematoma.
It is uncommon to have a large intra-axial calcified lesion as seen in this case. Differential diagnosis would include calcified intracerebral neoplasm, calcified meningioma (if extra-axial), and CAPNON.
Some extra-axial lesions can appear as intra-axial and differentiation can be difficult even with MRI examination. The exact diagnosis would depend on histology. However, the patient refused any surgical interference.
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