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.
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.
Authors: S Immenga; R Lodewijkx; Y B W E M Roos; S Middeldorp; C B L M Majoie; H C Willems; W P Vandertop; D Verbaan Journal: Trials Date: 2022-01-18 Impact factor: 2.279