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Chronic subdural haematoma in young and extremely aged adults: a comparative study of two age groups
Po-Chou Liliang1, Yu-Duan Tsai, Cheng-Long Liang
1Department of Neurosurgery, Chang Gung Memorial Hospital, Kaohsiung Medical Center, 123 Tapei Road, Niaosung Hsiang, Kaohsiung Hsien, Taiwan.
Insights
Younger adults with chronic subdural hematoma (CSDH) often present with headache and vomiting after severe trauma. Older adults typically show mental changes and motor deficits with larger hematomas.
Area of Science:
- Neurosurgery
- Geriatric Medicine
- Trauma Surgery
Background:
- Chronic subdural hematoma (CSDH) is a common neurosurgical condition.
- CSDH presentation and outcomes can vary significantly with patient age.
- Understanding age-specific differences is crucial for diagnosis and management.
Purpose of the Study:
- To compare clinical presentation, etiology, and outcomes of CSDH in young (<40 years) versus extremely aged (>75 years) adults.
- To identify age-related characteristics influencing CSDH presentation and management.
- To inform clinical suspicion and prompt evaluation for CSDH across different age groups.
Main Methods:
- Retrospective analysis of clinical data, CT findings, and surgical outcomes.
- Stratification of patients into two groups: young adults (<40 years) and extremely aged adults (>75 years).
- Statistical comparison of clinical characteristics, etiological factors, and surgical outcomes between the groups.
Main Results:
- Younger CSDH patients exhibited a higher incidence of headache and vomiting, shorter trauma-to-operation duration, and more severe trauma.
- Older CSDH patients presented more frequently with mental changes, motor deficits, and larger hematoma size.
- No statistically significant difference in surgical complication rates was observed between the young and extremely aged groups.
Conclusions:
- CSDH presents with distinct clinical features in young versus extremely aged adults.
- Younger patients are more prone to symptoms like headache and vomiting following significant trauma.
- Older patients often exhibit neurological deficits and larger hematomas, necessitating tailored clinical suspicion.
Abstract:
To compare the clinical presentation, etiological factors and the outcome of chronic subdural haematoma (CSDH) in young and old adults, a retrospective analysis was performed by differentiating young adults, age<40 years (n=24) versus extremely aged adults, age>75 years (n=51). The clinical data, computed tomography (CT) findings and surgical outcome were recorded for analysis. We observed certain characteristics particular to young CSDH patients, higher incidence of headache (P<0.001) and vomiting (P=0.009), the shorter duration from trauma to operation (P=0.018) and more severe traumatic episodes (P=0.001). The older patients had a higher frequency of mental change (P=0.006), motor deficits (P=0.014) and larger haematomas (P<0.001). The surgical complication rate was not statistically different between the two age groups. An understanding of the varied clinical presentation of CSDH is essential to stimulate clinical suspicion and prompt evaluation, particularly for the differences between young and extremely aged patients.