[Chronic subdural hematoma - assessment and management]

Abstract

Subdural hematomas (SDH) are associated with an increased morbidity and mortality and generally occur as chronic SDH among older patients. The most frequent signs and symptoms - like headache, alteration of consciousness, gait impairment and hemiparesis - are also prevalent among other diseases, which has to be taken into account in the differential diagnosis. In the case of symptomatic patients with focal neurological deficits, a surgical intervention should be considered, whereas in case of asymptomatic patients or patients with only slight headaches, also a conservative treatment with a clinical and radiological follow-up might be a possibility. Also after surgical intervention, the recurrence rate is between 5 and 33%. Therefore, all patients with chronic SDH depict, irrespective of the indication for an oral anticoagulation, a challenge for the treating physicians.