Increasing incidence of chronic subdural haematoma in the elderly

Adhiyaman, Vedamurthy; Chattopadhyay, Indrajit; Irshad, Fahd; Curran, David; Abraham, Samuel V

doi:10.1093/qjmed/hcw231

Cited by 44 publications

(50 citation statements)

References 21 publications

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“…Many studies, reported CSDH recurrence rate around 10-15% 3,8,13,17,25) and elderly patients had higher rate recurrence than younger ones 2,5,6,17) . In our series the recurrence rate in the elderly group was 20%.…”

Section: Discussionmentioning

confidence: 99%

“…In patients with CSDH using antithrombotic drugs, careful decision-making is compulsory, because these therapies are more common in non-traumatized CSDH patients with cerebrovascular and/or cardiovascular co-morbidities 20) . Furthermore, antiplatelet and anticoagulant drugs may increase the probability of CSDH recurrence as well as the VII factor deficit in young patients 2,8) .…”

Section: Discussionmentioning

confidence: 99%

“…It is well established that a head trauma, even mild, is the most common cause of CSDH with a incidence rate of 50-80% 3) . In the elderly group, history of mild head trauma was documented in 72% of patients, according to literature 2,15) . In our series one patient reported a moderate brain trauma with associated vertebral fracture treated with vertebral stabilization [9][10][11] .…”

Section: Discussionmentioning

confidence: 99%

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Clinical Outcome of Patients Over 90 Years of Age Treated for Chronic Subdural Hematoma

Dobran

Marini

Nasi

et al. 2022

J Korean Neurosurg Soc

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Objective : Chronic subdural hematoma (CSDH) is one of the most common pathology in daily neurosurgical practice and incidence increases with age. The aim of this study was to evaluate the prognostic factors and surgical outcome of CSDH in patients aging over 90 years compared with a control group of patients aging under 90 years. Methods : This study reviewed 25 patients with CSDH aged over 90 years of age treated in our department. This group was compared with a younger group of 25 patients aged below their eighties. At admission past medical history was recorded concerning comorbidities (hypertension, dementia, ictus cerebri, diabetes, and heart failure or attack). History of alcohol abuse, anticoagulant and antiplatelet therapy, head trauma and seizures were analyzed. Standard neurological examination and Markwalder score at admission, 48 hours after surgery and 1-6 months follow-up, radiologic data including location and CSDH maximum thickness were also evaluated. Results : Their mean age was 92.8 years and the median was 92.4 years (range, 90-100 years). In older group, the Markwalder evaluation at one month documented the complete recovery of 24 patients out of 25 without statistical difference with the younger group. This data was confirmed at 6-month follow-up. One patient died from cardiovascular failure 20 days after surgery. The presence of comorbidities, risk factors (antiplatelet therapy, anticoagulant therapy, history of alcohol abuse, and head trauma), preoperative symptoms, mono or bilateral CSDH, maximum thickness of hematoma, surgical time and recurrence were similar and statistically not significant in both groups. Conclusion : In this study, we demonstrate that surgery for very old patients above 90 years of age affected by CSDH is safe and allows complete recovery. Comparing two groups of patients above and under 90 years old we found that complication rate and recovery were similar in both groups.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Clinical Outcome of Patients Over 90 Years of Age Treated for Chronic Subdural Hematoma

Dobran

Marini

Nasi

et al. 2022

J Korean Neurosurg Soc

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“…The incidence rates of CSDH have been well described in higher-income regions of the world, and they demonstrate a positive correlation with increasing age; in a Japanese cohort, an incidence rate of 58 per 100,000 per year was noted in people above the age of 70 years, and a Welsh study reported an incidence rate of 273 per 100,000 per year in the population aged 95 years and above [4,5].…”

Section: Introductionmentioning

confidence: 92%

Chronic subdural hematomas: a case series from the medical ward of a north Tanzanian referral hospital

et al. 2019

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Background: Chronic subdural hematomas (CSDH) initially present as focal neurological deficits with or without signs of increased intracranial pressure, for which admission to the general medical ward may occur if they present with poorly understood neurological deficits and no evident history of trauma. The symptoms may be long standing and mimic stroke upon presentation. Their distribution and specific clinical features in sub-Saharan Africa are largely unknown. Methods: We describe a series of subdural hematoma (SDH) inpatients from the medical ward of a tertiary referral center in Northern Tanzania, describing clinical and radiological characteristics and providing clinical outcome where possible. Results: Our study population numbered 30, with a male majority (n = 19, 63.3%) and a mean age of 66.8 ± 14.5 years. Mean duration from symptom onset to admission in the medical ward was 20.0 ± 30.8 days. History of head injury was reported in only 43.3% of patients. Improvement in the neurological examination was noted in 68.1% of the 22 patients who underwent surgery. The mortality rate was 20.0%. Conclusion: A majority of the patients were elderly males and presented late to the hospital. Delayed presentation and diagnosis due to, amongst other reasons, postponed imaging resulted in a prolonged time to definitive treatment and a high mortality rate compared to other regions of the world.

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“…The overall incidence of CSDHs is estimated at 1.7 to 21 per 100 000 persons per year. 2,3 Throughout all the meninges, the subdural space is less tight and potentially vulnerable to trauma, when compared to the junctional layers of dura and arachnoid membrane. The layer of duraarachnoid interface, commonly designated as subdural space, is composed of the dural border cells.…”

Section: Introductionmentioning

confidence: 99%

CT-Based Quantitative Analysis for Pathological Features Associated With Postoperative Recurrence and Potential Application Upon Artificial Intelligence: A Narrative Review With a Focus on Chronic Subdural Hematomas

Kung

Lin

2020

Mol Imaging

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Chronic subdural hematomas (CSDHs) frequently affect the elderly population. The postoperative recurrence rate of CSDHs is high, ranging from 3% to 20%. Both qualitative and quantitative analyses have been explored to investigate the mechanisms underlying postoperative recurrence. We surveyed the pathophysiology of CSDHs and analyzed the relative factors influencing postoperative recurrence. Here, we summarize various qualitative methods documented in the literature and present our unique computer-assisted quantitative method, published previously, to assess postoperative recurrence. Imaging features of CSDHs, based on qualitative analysis related to postoperative high recurrence rate, such as abundant vascularity, neomembrane formation, and patent subdural space, could be clearly observed using the proposed quantitative analysis methods in terms of mean hematoma density, brain re-expansion rate, hematoma volume, average distance of subdural space, and brain shifting. Finally, artificial intelligence (AI) device types and applications in current health care are briefly outlined. We conclude that the potential applications of AI techniques can be integrated to the proposed quantitative analysis method to accomplish speedy execution and accurate prediction for postoperative outcomes in the management of CSDHs.

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Increasing incidence of chronic subdural haematoma in the elderly

Cited by 44 publications

References 21 publications

Clinical Outcome of Patients Over 90 Years of Age Treated for Chronic Subdural Hematoma

Clinical Outcome of Patients Over 90 Years of Age Treated for Chronic Subdural Hematoma

Chronic subdural hematomas: a case series from the medical ward of a north Tanzanian referral hospital

CT-Based Quantitative Analysis for Pathological Features Associated With Postoperative Recurrence and Potential Application Upon Artificial Intelligence: A Narrative Review With a Focus on Chronic Subdural Hematomas

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