An Unusual Presentation of Chronic Subdural Hematoma—“Subdural Mud”

Abstract Chronic subdural hematoma (SDH) is widely seen in neurosurgical practice, however, the incidence of calcification or ossification in chronic SDH is a rare finding with an incidence of 0.3 to 2.7%. We report a case of an 85-year-old male after having undergone a parietal burr hole craniectomy for left-sided chronic SDH at a hospital in his locality, presented with a drop in conscious level, Glasgow Coma Scale of 9/15 (E3V1M5) with left-sided hemiparesis. A computed tomography scan revealed a thick left subdural collection with multiple densities along with a right capsuloganglionic bleed with intraventricular extension, which was successfully and completely removed, with progressive clinical improvement. Intraoperatively, as the SDH had the consistency and color, like that of mud/clay with thick membranes, it is referred to as “subdural mud.” In our case, surgical intervention did improve the neurological and functional outcome of the patient which supports the fact that surgery is indicated in patients with calcified chronic SDH with acute or progressive neurological deterioration.