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Uncal herniation results in poor outcomes in patients with SIH complicated with SDH. In individuals with SDH ≥10 mm and decreased GCS scores, early surgical evacuation might prevent uncal herniation.

Our study aimed to examine the contribution of commonly used tools, including the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA), and develop a formula for conversion of these tests in the Chinese population. We also create a predictive model for the detection of Chinese patients' mild cognitive impairment (MCI). We recruited 168 patients with Parkinson's disease (PD) from 12 medical centres or teaching hospitals in Taiwan, and each participant received a comprehensive neuropsychological assessment. Logistic regression analysis was conducted to find predictors of MCI with the help of a generalized additive model. We found that patients with an MMSe > 25 or a MoCA > 21 were less likely to have MCI. The discrimination powers of the two tests used for detecting MCI were 0.902 and 0.868, respectively, as measured by the area under the receiver operating characteristic curve (ROC). The best predictive model suggested that patients with a higher MMSE score, delayed recall scores of the 12-item Word Recall Test ≥ 5.817, and no test decline in the visuospatial index were less likely to have MCI (ROC = 0.982). Our findings have clinical utility in MCI detection in Chinese PD and need a larger sample to confirm. Evidence showed that non-motor symptoms are common in patients with movement disorders, Parkinson's disease (PD) 1 , in which cognitive dysfunction is the most troublesome symptom. The patients' cognitive profile is heterogeneous, and it is urgently needed to detect the subtle changes of cognitive function before full-brown dementia 2-4. In the PD population, mild cognitive impairment (MCI) is believed to be a forerunner of dementia, and the prevalence of MCI in PD population is around 26.7% (range: 18.9%-38.2%) 5. For detecting MCI, diagnostic criteria were suggested by the Movement Disorder Society (MDS), and this criterion has two means to clarify PD patients with MCI. The level I contain the usage of screening tools and the level II involved in the multiple neuropsychological assessments 6. Clinically, physicians use brief screening tools to measure the patient's mentality can meet the level I's requirement. That is, Level I has high clinical utility. Two most frequently used screening instruments, Mini-Mental State Examination (MMSE) 7 and the Montreal Cognitive Assessment (MoCA) 8 , applied for screening cognitive dysfunction in patients with Alzheimer's disease (AD) in clinical practice 9. However, their clinical utility in the PD population is disputed, especially in the PD population from Eastern countries. MMSE is a universally accepted test and is a handy tool to detect cognitive dysfunction in PD population 10,11. However, it is prone to ceiling effects and does not provide adequate sensitivity