Bilateral calcified chronic subdural hematoma. Further pathogenetic and clinical consideration on the so-called "armored brain".

Calcified chronic subdural hematomas after shunting procedures for treatment of hydrocephalus have been rarely described. When the calcified wall is so large to extensively cover the surface of the cerebral hemispheres, this instance has been defined "Armored Brain". The Authors report the case of an eleven-year-old patient affected by triventricular hydrocephalus due to aqueductal stenosis, that was treated by a ventriculoatrial shunt. The post-operative course was uneventful and the patient recovered completely from the preexisting neurological deficits. Nevertheless, a CT scan performed 2 and 1/2 years later, revealed the development of a bilateral calcified chronic subdural hematoma, to such extent to configure a so-called "Armored Brain". Clinical course, pathogenesis and treatment of such kind of pathology are discussed in light of the data reported from the literature.