[Chronic subdural hematoma: a disease of elderly people]

Abstract

Background: The lack of specificity and heterogeneity of the clinical picture of chronic subdural hematoma, hampers its diagnosis.

Aim: To report the experience of a Neurosurgical Service in chronic subdural hematoma.

Patients and methods: One hundred patients (77 male, mean age 77 +/- 13 years) with chronic subdural hematoma were analyzed.

Results: The main clinical presentations were mental status changes (50%) and progressive focal neurological deficit (46%). Five cases presented as a transient neurological deficit. All patients were treated with burr hole drainage. Thirteen had recurrence of the hematoma and they were reoperated. The surgical mortality was 3%. Eighty seven patients were followed for a mean of 66 months. Eighty one of these had a complete recovery, 6 had permanent neurological deficit and 2 of these were unable to care for themselves. Bad prognosis was associated with the absence of a previous trauma to explain the hematoma and symptoms of dementia as the clinical presentation.

Conclusions: Most patients with chronic subdural hematoma treated with burr hole drainage have a good outcome.