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

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Abstract

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.

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References

  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 95:290–292

    Article  PubMed  Google Scholar 

  2. Gonugunta V, Buxton N (2001) Warfarin and chronic subdural haematomas. Br J Neurosurg 15:514–517

    Article  CAS  PubMed  Google Scholar 

  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 35:123–127

    CAS  PubMed  Google Scholar 

  4. Jones S, Kafetz K (1999) A prospective study of chronic subdural haematomas in elderly patients. Age Ageing 28:519–521

    Article  CAS  PubMed  Google Scholar 

  5. König SA, Schick U, Döhnert J, Goldammer A, Vitzhum HE (2003) Coagulopathy and outcome in patients with chronic subdural haematoma. Acta Neurol Scand 107:110–116

    Article  PubMed  Google Scholar 

  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 33:345–348

    Article  PubMed  Google Scholar 

  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) 41:371–381

    Google Scholar 

  8. Nakaguchi H, Tanishima T, Yoshimasu N (2001) Factors in the natural history of chronic subdural hematomas that influence their postoperative recurrence. J Neurosurg 95:256–262

    CAS  PubMed  Google Scholar 

  9. Odén A, Fahlén M (2002) Oral anticoagulation and risk of death: a medical record linkage study. Br Med J 325:1073–1075

    Google Scholar 

  10. Oishi M, Toyama M, Tamatani S, Kitazawa T, Saito M (2001) Clinical factors of recurrent chronic subdural hematoma. Neurol Med Chir (Tokyo) 41:382–386

    Google Scholar 

  11. Pencalet P (2001) Complications of chronic subdural hematoma in the adult. Neurochirurgie 47:491–494

    CAS  PubMed  Google Scholar 

  12. Reymond MA, Marbet G, Radü EW, Gratzl O (1992) Aspirin as a risk factor for hemorrhage in patients with head injuries. Neurosurg Rev 15:21–25

    CAS  PubMed  Google Scholar 

  13. Sambasivan M (1997) An overview of chronic subdural hematoma: experience with 2300 cases. Surg Neurol 47:418–422

    Article  CAS  PubMed  Google Scholar 

  14. Spallone A, Giuffre R, Gagliardi FM, Vagnozzi R (1989) Chronic subdural haematoma in extremely aged patients. Eur Neurol 29:18–22

    CAS  PubMed  Google Scholar 

  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 131:177–182

    PubMed  Google Scholar 

  16. Weigel R, Schmiedek P, Krauss JK (2003) Outcome of contemporary surgery for chronic subdural haematoma: evidence based review. J Neurol Neurosurg Psychiatry 74:937–943

    Article  CAS  PubMed  Google Scholar 

  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) 143:811–819

    Google Scholar 

  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 97:194–196

    CAS  PubMed  Google Scholar 

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Acknowledgement

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

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Correspondence to H. Baechli.

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Baechli, H., Nordmann, A., Bucher, H.C. et al. Demographics and prevalent risk factors of chronic subdural haematoma: results of a large single-center cohort study. Neurosurg Rev 27, 263–266 (2004). https://doi.org/10.1007/s10143-004-0337-6

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  • DOI: https://doi.org/10.1007/s10143-004-0337-6

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