Chronic subdural hematoma in patients under age 65 years: A comparative study of age cohort

Abstract

Chronic subdural hematoma (CSDH) in patients 65 years old is not uncommon, but its exact situation is not well-clarified. In this study, we compare the clinical variables between two age groups (≤65 years and >65 years), and focus on the characteristics of younger adults. In this 2-year retrospective study, 98 patients with CSDH were enrolled and subdivided into younger (≤65 years) and older (>65 years) groups. Information about presenting symptoms and neuroimages was recorded. We also investigated recurrence, morbidity, mortality, and neurological outcome after burr hole craniotomy. The patients ≤65 years accounted for 29% of the CSDH cases. Younger adults had a lower incidence of hemiparesis than older patients (p = 0.03). Analysis of the computerized tomography (CT) scans on admission revealed differences in layering of the hematoma (p = 0.009) and multiplicity of hematoma cavities (p = 0.001). The recurrence rate was 18% for the younger group and 13% for the older group (p = 0.53). The occurrence of postoperative morbidity and mortality was similar in the two age groups (p > 0.99 and p = 0.56, respectively). An unfavorable Glasgow Outcome Scale was not observed in any of the younger patients, but was seen in six of the older patients; however, there was no statistically significant difference between the age groups (p = 0.18). The clinical presentations and CT features of patients ≤65 years of age varied from those of older patients. Clinicians should note this variability to facilitate proper management.