Skip to main content
PMC home page
Postgraduate Medical Journal logoLink to Postgraduate Medical Journal
. 2002 Feb;78(916):71–75. doi: 10.1136/pmj.78.916.71

Chronic subdural haematoma in the elderly

V Adhiyaman 1, M Asghar 1, K Ganeshram 1, B Bhowmick 1
PMCID: PMC1742254  PMID: 11807186

Abstract

Chronic subdural haematoma is predominantly a disease of the elderly. It usually follows a minor trauma. A history of direct trauma to the head is absent in up to half the cases. The common manifestations are altered mental state and focal neurological deficit. Neurological state at the time of diagnosis is the most important prognostic factor. Morbidity and mortality is higher in the elderly but outcome is good in patients who undergo neurosurgical intervention.

Full Text

The Full Text of this article is available as a PDF (109.7 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Abdulla A. J., Pearce V. R. Reversible akinetic-rigid syndrome due to bilateral subdural haematomas. Age Ageing. 1999 Oct;28(6):582–583. doi: 10.1093/ageing/28.6.582. [DOI] [PubMed] [Google Scholar]
  2. Ashkenazi E., Pomeranz S. Nystagmus as the presentation of tentorial incisure subdural haematoma. J Neurol Neurosurg Psychiatry. 1994 Jul;57(7):830–831. doi: 10.1136/jnnp.57.7.830. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Bender M. B., Christoff N. Nonsurgical treatment of subdural hematomas. Arch Neurol. 1974 Aug;31(2):73–79. doi: 10.1001/archneur.1974.00490380021001. [DOI] [PubMed] [Google Scholar]
  4. Cameron M. M. Chronic subdural haematoma: a review of 114 cases. J Neurol Neurosurg Psychiatry. 1978 Sep;41(9):834–839. doi: 10.1136/jnnp.41.9.834. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Cole G. Intracranial space-occupying masses in mental hospital patients: necropsy study. J Neurol Neurosurg Psychiatry. 1978 Aug;41(8):730–736. doi: 10.1136/jnnp.41.8.730. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Ellis G. L. Subdural hematoma in the elderly. Emerg Med Clin North Am. 1990 May;8(2):281–294. [PubMed] [Google Scholar]
  7. FELDMAN R. G., PINCUS J. H., MCENTEE W. J. CEREBROVASCULAR ACCIDENT OR SUBDURAL FLUID COLLECTION? Arch Intern Med. 1963 Dec;112:966–976. doi: 10.1001/archinte.1963.03860060178020. [DOI] [PubMed] [Google Scholar]
  8. Foelholm R., Waltimo O. Epidemiology of chronic subdural haematoma. Acta Neurochir (Wien) 1975;32(3-4):247–250. doi: 10.1007/BF01405457. [DOI] [PubMed] [Google Scholar]
  9. Fogelholm R., Heiskanen O., Waltimo O. Chronic subdural hematoma in adults. Influence of patient's age on symptoms, signs, and thickness of hematoma. J Neurosurg. 1975 Jan;42(1):43–46. doi: 10.3171/jns.1975.42.1.0043. [DOI] [PubMed] [Google Scholar]
  10. Han J. S., Kaufman B., Alfidi R. J., Yeung H. N., Benson J. E., Haaga J. R., El Yousef S. J., Clampitt M. E., Bonstelle C. T., Huss R. Head trauma evaluated by magnetic resonance and computed tomography: a comparison. Radiology. 1984 Jan;150(1):71–77. doi: 10.1148/radiology.150.1.6689790. [DOI] [PubMed] [Google Scholar]
  11. Henderson M. J. A difficult psychiatric patient. Postgrad Med J. 2000 Sep;76(899):585, 590-1. doi: 10.1136/pmj.76.899.585. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Hilt D. C., Alexander G. E. Jacksonian somatosensory seizures as the sole manifestation of chronic subdural hematoma. Arch Neurol. 1982 Dec;39(12):786–786. doi: 10.1001/archneur.1982.00510240048017. [DOI] [PubMed] [Google Scholar]
  13. Hosoda K., Tamaki N., Masumura M., Matsumoto S., Maeda F. Magnetic resonance images of chronic subdural hematomas. J Neurosurg. 1987 Nov;67(5):677–683. doi: 10.3171/jns.1987.67.5.0677. [DOI] [PubMed] [Google Scholar]
  14. Ito H., Yamamoto S., Saito K., Ikeda K., Hisada K. Quantitative estimation of hemorrhage in chronic subdural hematoma using the 51Cr erythrocyte labeling method. J Neurosurg. 1987 Jun;66(6):862–864. doi: 10.3171/jns.1987.66.6.0862. [DOI] [PubMed] [Google Scholar]
  15. Jones S., Kafetz K. A prospective study of chronic subdural haematomas in elderly patients. Age Ageing. 1999 Oct;28(6):519–521. doi: 10.1093/ageing/28.6.519. [DOI] [PubMed] [Google Scholar]
  16. Karasawa H., Tomita S., Suzuki S. Chronic subdural hematomas. Time-density curve and iodine concentration in enhanced CT. Neuroradiology. 1987;29(1):36–39. doi: 10.1007/BF00341034. [DOI] [PubMed] [Google Scholar]
  17. Kelly A. B., Zimmerman R. D., Snow R. B., Gandy S. E., Heier L. A., Deck M. D. Head trauma: comparison of MR and CT--experience in 100 patients. AJNR Am J Neuroradiol. 1988 Jul-Aug;9(4):699–708. [PMC free article] [PubMed] [Google Scholar]
  18. Kim K. S., Hemmati M., Weinberg P. E. Computed tomography in isodense subdural hematoma. Radiology. 1978 Jul;128(1):71–74. doi: 10.1148/128.1.71. [DOI] [PubMed] [Google Scholar]
  19. Lee K. S., Bae W. K., Bae H. G., Doh J. W., Yun I. G. The computed tomographic attenuation and the age of subdural hematomas. J Korean Med Sci. 1997 Aug;12(4):353–359. doi: 10.3346/jkms.1997.12.4.353. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Lesoin F., Destee A., Jomin M., Warot P., Wilson S. G. Quadriparesis as an unusual manifestation of chronic subdural haematoma. J Neurol Neurosurg Psychiatry. 1983 Aug;46(8):783–785. doi: 10.1136/jnnp.46.8.783. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Luxon L. M., Harrison M. J. Chronic subdural haematoma. Q J Med. 1979 Jan;48(189):43–53. [PubMed] [Google Scholar]
  22. Maeshima S., Okumura Y., Nakai K., Itakura T., Komai N. Gerstmann's syndrome associated with chronic subdural haematoma: a case report. Brain Inj. 1998 Aug;12(8):697–701. doi: 10.1080/026990598122250. [DOI] [PubMed] [Google Scholar]
  23. Maurice-Williams R. S. Bedside treatment of chronic subdural haematoma? Lancet. 2001 Apr 28;357(9265):1308–1309. doi: 10.1016/s0140-6736(00)04528-1. [DOI] [PubMed] [Google Scholar]
  24. Melamed E., Lavy S., Reches A., Sahar A. Chronic subdural hematoma simulating transient cerebral ischemic attacks. Case report. J Neurosurg. 1975 Jan;42(1):101–103. doi: 10.3171/jns.1975.42.1.0101. [DOI] [PubMed] [Google Scholar]
  25. Moster M. L., Johnston D. E., Reinmuth O. M. Chronic subdural hematoma with transient neurological deficits: a review of 15 cases. Ann Neurol. 1983 Nov;14(5):539–542. doi: 10.1002/ana.410140508. [DOI] [PubMed] [Google Scholar]
  26. Naganuma H., Fukamachi A., Kawakami M., Misumi S., Nakajima H., Wakao T. Spontaneous resolution of chronic subdural hematomas. Neurosurgery. 1986 Nov;19(5):794–798. doi: 10.1227/00006123-198611000-00013. [DOI] [PubMed] [Google Scholar]
  27. Phookan G., Cameron M. Bilateral chronic subdural haematoma: an unusual presentation with isolated oculomotor nerve palsy. J Neurol Neurosurg Psychiatry. 1994 Sep;57(9):1146–1146. doi: 10.1136/jnnp.57.9.1146. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Potter J. F., Fruin A. H. Chronic subdural hematoma--the "great imitator". Geriatrics. 1977 Jun;32(6):61–66. [PubMed] [Google Scholar]
  29. Reinges M. H., Hasselberg I., Rohde V., Küker W., Gilsbach J. M. Prospective analysis of bedside percutaneous subdural tapping for the treatment of chronic subdural haematoma in adults. J Neurol Neurosurg Psychiatry. 2000 Jul;69(1):40–47. doi: 10.1136/jnnp.69.1.40. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Rozzelle C. J., Wofford J. L., Branch C. L. Predictors of hospital mortality in older patients with subdural hematoma. J Am Geriatr Soc. 1995 Mar;43(3):240–244. doi: 10.1111/j.1532-5415.1995.tb07329.x. [DOI] [PubMed] [Google Scholar]
  31. Sandyk R. Isolated failure of upward gaze as a sign of chronic subdural haematoma. S Afr Med J. 1982 Jan 9;61(2):32–32. [PubMed] [Google Scholar]
  32. Sato S., Suzuki J. Ultrastructural observations of the capsule of chronic subdural hematoma in various clinical stages. J Neurosurg. 1975 Nov;43(5):569–578. doi: 10.3171/jns.1975.43.5.0569. [DOI] [PubMed] [Google Scholar]
  33. Schaller B., Radziwill A. J., Wasner M., Gratzl O., Steck A. J. Fluktuierende Paraparese als Manifestation eines bilateralen chronischen Subduralhämatoms. Schweiz Med Wochenschr. 1999 Jul 27;129(29-30):1067–1072. [PubMed] [Google Scholar]
  34. Sharma B. S., Tewari M. K., Khosla V. K., Pathak A., Kak V. K. Tension pneumocephalus following evacuation of chronic subdural haematoma. Br J Neurosurg. 1989;3(3):381–387. doi: 10.3109/02688698909002819. [DOI] [PubMed] [Google Scholar]
  35. Smely C., Madlinger A., Scheremet R. Chronic subdural haematoma--a comparison of two different treatment modalities. Acta Neurochir (Wien) 1997;139(9):818-25, discussion 825-6. doi: 10.1007/BF01411399. [DOI] [PubMed] [Google Scholar]
  36. Snow R. B., Zimmerman R. D., Gandy S. E., Deck M. D. Comparison of magnetic resonance imaging and computed tomography in the evaluation of head injury. Neurosurgery. 1986 Jan;18(1):45–52. doi: 10.1227/00006123-198601000-00008. [DOI] [PubMed] [Google Scholar]
  37. Sunada I., Inoue T., Tamura K., Akano Y., Fu Y. Parkinsonism due to chronic subdural hematoma. Neurol Med Chir (Tokyo) 1996 Feb;36(2):99–101. doi: 10.2176/nmc.36.99. [DOI] [PubMed] [Google Scholar]
  38. Traynelis V. C. Chronic subdural hematoma in the elderly. Clin Geriatr Med. 1991 Aug;7(3):583–598. [PubMed] [Google Scholar]
  39. Wali G. M. "Ease of falling" syndrome associated with subdural haematoma. J Neurol Neurosurg Psychiatry. 1994 Sep;57(9):1144–1145. doi: 10.1136/jnnp.57.9.1144. [DOI] [PMC free article] [PubMed] [Google Scholar]
  40. Weir B. The osmolality of subdural hematoma fluid. J Neurosurg. 1971 Apr;34(4):528–533. doi: 10.3171/jns.1971.34.4.0528. [DOI] [PubMed] [Google Scholar]
  41. Welsh J. E., Tyson G. W., Winn H. R., Jane J. A. Chronic subdural hematoma presenting as transient neurologic deficits. Stroke. 1979 Sep-Oct;10(5):564–567. doi: 10.1161/01.str.10.5.564. [DOI] [PubMed] [Google Scholar]
  42. van Havenbergh T., van Calenbergh F., Goffin J., Plets C. Outcome of chronic subdural haematoma: analysis of prognostic factors. Br J Neurosurg. 1996 Feb;10(1):35–39. doi: 10.1080/02688699650040502. [DOI] [PubMed] [Google Scholar]

Articles from Postgraduate Medical Journal are provided here courtesy of BMJ Publishing Group

RESOURCES