Study on clinical features and factors associated with thickness of chronic subdural hematoma in adult

Ruhul Kuddus,S K Sader Hossain,A T M Mosharef Hossain,Robert Ahmed Khan,K Nabi Khan,M Afzal Hossain,Kanak Kanti Barua,Atikur Rahman,Haradan Debnath

doi:10.3329/bsmmuj.v11i3.37701

Abstract

<p class="Abstract">Patients with chronic subdural hematoma encounter certain difficulties in diagnosis, especially in elderly, due to the characteristically non-specific symptoms and signs. Early diagnosis and proper operative treatment, on the other hand, results in complete recovery in most of the cases. In this study, the clinical features and factors of 31 patients with chronic subdural hematoma, associated with the thickness of chronic subdural hematoma were analyzed. The mean age was 62 ± 13.9 years. The maximum hematoma thickness in the axial CT scan was 25 mm. The thickness of hematoma obtained from axial plain CT had a positive relationship with the patient’s age where r=0.895 and p&lt;0.001 signifies that the thickness of hematoma increased with the increasing age. But the hematoma thickness was not related to co-morbidity such as diabetes mellitus, hypertension and ischemic heart disease. The presentation of the patient with higher hematoma thickness with hemiparesis was statistically significant and with lower thickness with headache and vomiting.</p>

Highlights

The chronic subdural hematoma is relatively common and its outcome without operative treatment is almost invariably fatal
Developing slowly in time, in weeks or months, the aspect that chronic subdural hematoma usually occurs in elder should not be neglected, its clinical symptomatology often debuting with memory and attention disorders, so that the patient is usually referred to the psychiatrist or neurologist, only a paraclinical investigation (CT scan or magnetic resonance imaging (MRI)) being able to establish the diagnosis.[9]
The overall clinical presentation of chronic subdural hematoma patients according to the frequency was headache 64.5%, history of head trauma 64.5%, mental symptoms with or without impaired consciousness 58%, hemiparesis 54.8%, altered consciousness level 41.9%, and vomiting 22.6% (Table I)

Summary

Introduction

The chronic subdural hematoma is relatively common and its outcome without operative treatment is almost invariably fatal. One encounters certain difficulties in the diagnosis, especially in the elderly patient, due to the characteristically non-specific symptoms and signs.[1,2,3] In these studies, the clinical features and factors associated with the thickness of chronic subdural hematoma were analyzed. The observation that older patient has a longer time interval from the trauma to the operation and that the hematoma is thicker at the time of CT scan than that in young person seem to be a logical result of the changes that occur in the aging brain. Developing slowly in time, in weeks or months, the aspect that chronic subdural hematoma usually occurs in elder should not be neglected, its clinical symptomatology often debuting with memory and attention disorders, so that the patient is usually referred to the psychiatrist or neurologist, only a paraclinical investigation (CT scan or MRI) being able to establish the diagnosis.[9]. This study will help the neurosurgeon of our country in a proper understanding of the clinicoradiological presentations and management of chronic subdural hematoma

Materials and Methods

Results

Discussion

Conclusion