Subdural hematoma. Presentation and management in older adults

Subdural hematomas pose diagnostic and therapeutic difficulties in older adults. Presenting signs and symptoms of subdural hematomas--headache, confusion, ataxia, and hemiparesis--can mimic other diseases such as dementia, stroke, transient ischemic attacks, neoplasm, and normal pressure hydrocephalus. Patients with subdural hematomas and focal neurologic signs should be considered for surgical Intervention, whereas asymptomatic patients or patients with only complaints of a headache can be managed medically or followed with serial neuroimaging by computed tomography. Patients who have been chronically anticoagulated pose a dilemma when they present with a subdural hematoma.