Series Study of Sub acute and Chronic Subdural Haematoma

Abstract

Background: Subacute and chronic subdural haematoma is a common problem in the elderly population. It occurs in the context of cerebral degeneration. Trauma, intracranial hypotension, coagulopathy and chronic alcoholism are also predisposing factors. Clinical profile may present similarly to stroke, raised intracranial pressure (ICP) or dementia. CT and MRI are the diagnostic investigations. Burr hole craniostomy has good results in view of improvement and recurrence.Objective: The aim of this study is to determine the epidemiology, clinical profile, optimum surgical procedure, postoperative course and recurrence of patients with SDH and to compare with the literature.Methods: This is a prospective series study of 50 cases. Multifactorial analysis was performed.Results: Eighty four percent were older than 60 years. 10% were older than 90years. Trauma(42%), coagulopathy (18%) and alcoholism (12%) were the risk factors found. 92% mimicked stroke in presentation. 56% had raised ICT. 14% were comatose. Burr hole drainage was done. It showed improvement in 92%, recurrence in 16% and mortality in 6%. Survival rate after 90 years was 60%. Conclusion:SDH is a problem common in elderly. Clinically it often mimics stroke. Burr hole craniostomy is optimum surgery for SDH. Surgery can be successful after 90 years also.

Thirty-day clinical outcome of traumatic brain injury patients with acute extradural and subdural hematoma: a cohort study at Mulago National Referral Hospital, Uganda

“…Acute on chronic subdural hematoma may occur in the absence of trauma [27]. In some cases, the trauma may be as trivial as a slap [16]. This aetiology does not match that of ASDH or AEDH, where the severity of injury corresponds to the gravity of trauma involved [8].…”

Surgical techniques for evacuation of chronic subdural hematoma: a mini-review

“…This condition has a compressive effect on the brain leading to neurological deficits that depend on the size and location of the hematoma. The incidence of cSDH is 8.2-14.0 per 100,000 people annually worldwide and is most common in patients over age 70 (3)(4)(5)(6)(7)(8)(9)(10)(11). Due to the aging of the population, the incidence of cSDH is anticipated to double by 2,037 (12,13).…”