Neurosurgical Review

, Volume 27, Issue 4, pp 263–266 | Cite as

Demographics and prevalent risk factors of chronic subdural haematoma: results of a large single-center cohort study

  • H. BaechliEmail author
  • A. Nordmann
  • H. C. Bucher
  • O. Gratzl
Original Article


Chronic subdural haematoma (CSDH) is a typical disease in elderly patients and encountered frequently in neurosurgical practice. With an increasing number of elderly people in the general population, there is a need to investigate risk factors (age, falls, anticoagulant or antithrombotic therapy) which could be pertinent to the development of this disease. We reviewed 354 patients undergoing surgery for CSDH over a period of 7 years (1996–2002), the occurrence being equally distributed over these years. CSDH occurred more often in elderly (≥65 years) than in younger people (69 vs 31%), and in men than in women (64 vs 36%). Falls were reported in 77% of patients. There was a trend towards a higher risk of falls in the elderly. Antithrombotic or anticoagulant therapy was present in 41% of patients, 32% of them having had falls. Overall postoperative mortality was 0% and overall recurrence rate 13.6%. CSDH in the elderly population, especially in men, is frequently associated with falls and anticoagulation or antithrombotic therapy. The indication for these medications, especially in elderly patients at risk for falls, should be carefully evaluated and controlled.


Chronic subdural haematoma Falls Anticoagulation or antithrombotic therapy Male preponderance Ageing 



We would like to thank Dr Helen Langemann for assistance with manuscript preparation.


  1. 1.
    Asghar M, Adhiyaman V, Greenway MW, Bhowmick BK, Bates A (2002) Chronic subdural haematoma in the elderly—a North Wales experience. J R Soc Med 95:290–292CrossRefPubMedGoogle Scholar
  2. 2.
    Gonugunta V, Buxton N (2001) Warfarin and chronic subdural haematomas. Br J Neurosurg 15:514–517CrossRefPubMedGoogle Scholar
  3. 3.
    Hostalot-Panisello C, Carrasco-Gonzales A, Bilbao-Barandica G, Pomposo-Gaztelu I, Garibi-Undabarrena JM (2002) Chronic subdural haematoma. Presentation and therapeutic attitudes. Rev Neurol 35:123–127PubMedGoogle Scholar
  4. 4.
    Jones S, Kafetz K (1999) A prospective study of chronic subdural haematomas in elderly patients. Age Ageing 28:519–521CrossRefPubMedGoogle Scholar
  5. 5.
    König SA, Schick U, Döhnert J, Goldammer A, Vitzhum HE (2003) Coagulopathy and outcome in patients with chronic subdural haematoma. Acta Neurol Scand 107:110–116CrossRefPubMedGoogle Scholar
  6. 6.
    Liliang P-C, Tsai Y-D, Liang C-L, Lee T-C, Chen H-J (2002) Chronic subdural haematoma in young and extremely aged adults: a comparative study of two age groups. Injury 33:345–348CrossRefPubMedGoogle Scholar
  7. 7.
    Mori K, Maeda M (2001) Surgical treatment of chronic subdural hematoma in 500 consecutive cases: clinical characteristics, surgical outcome, complications, and recurrence rate. Neurol Med Chir (Tokyo) 41:371–381Google Scholar
  8. 8.
    Nakaguchi H, Tanishima T, Yoshimasu N (2001) Factors in the natural history of chronic subdural hematomas that influence their postoperative recurrence. J Neurosurg 95:256–262PubMedGoogle Scholar
  9. 9.
    Odén A, Fahlén M (2002) Oral anticoagulation and risk of death: a medical record linkage study. Br Med J 325:1073–1075Google Scholar
  10. 10.
    Oishi M, Toyama M, Tamatani S, Kitazawa T, Saito M (2001) Clinical factors of recurrent chronic subdural hematoma. Neurol Med Chir (Tokyo) 41:382–386Google Scholar
  11. 11.
    Pencalet P (2001) Complications of chronic subdural hematoma in the adult. Neurochirurgie 47:491–494PubMedGoogle Scholar
  12. 12.
    Reymond MA, Marbet G, Radü EW, Gratzl O (1992) Aspirin as a risk factor for hemorrhage in patients with head injuries. Neurosurg Rev 15:21–25PubMedGoogle Scholar
  13. 13.
    Sambasivan M (1997) An overview of chronic subdural hematoma: experience with 2300 cases. Surg Neurol 47:418–422CrossRefPubMedGoogle Scholar
  14. 14.
    Spallone A, Giuffre R, Gagliardi FM, Vagnozzi R (1989) Chronic subdural haematoma in extremely aged patients. Eur Neurol 29:18–22PubMedGoogle Scholar
  15. 15.
    Tagle P, Mery F, Torrealba G, Del Villar S, Carmona H, Campos M, Mendez J, Chircharro A (2003) chronic subdural hematoma: a disease of elderly people. Rev Med Chil 131:177–182PubMedGoogle Scholar
  16. 16.
    Weigel R, Schmiedek P, Krauss JK (2003) Outcome of contemporary surgery for chronic subdural haematoma: evidence based review. J Neurol Neurosurg Psychiatry 74:937–943CrossRefPubMedGoogle Scholar
  17. 17.
    Weigel R, Schilling L, Schmiedek P (2001) Specific patterns of growth factor distribution in chronic subdural hematoma (CSH): evidence for an angiogenic disease. Acta Neurochir (Wien) 143:811–819Google Scholar
  18. 18.
    Wilkinson CC, Multani J, Bailes JE (2001) Chronic subdural hematoma presenting with symptoms of transient ischemic attack (TIA): a case report. W V Med J 97:194–196PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • H. Baechli
    • 1
    Email author
  • A. Nordmann
    • 2
  • H. C. Bucher
    • 2
  • O. Gratzl
    • 1
  1. 1.Department of NeurosurgeryUniversity Hospital BasleBaselSwitzerland
  2. 2.Department of Medicine/Basle Institute for Clinical EpidemiologyUniversity Hospital BasleBaselSwitzerland

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