Clinical pattern of chronic subdural haematoma
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1Department of Neurosurgery, Medical Academy of Lódź, Poland.
Insights
Chronic subdural hematoma (CSH) can mimic stroke symptoms and present with increased intracranial pressure. Neurological deficits are more common in older adults, and CSH may be missed if not suspected.
Area of Science:
- Neurosurgery
- Neurology
- Clinical Medicine
Background:
- Chronic subdural hematoma (CSH) is a significant neurological condition.
- Accurate diagnosis of CSH is crucial for timely intervention.
Purpose of the Study:
- To evaluate the clinical presentation of chronic subdural hematoma (CSH).
- To identify factors influencing CSH manifestation in adult patients.
Main Methods:
- Retrospective analysis of 131 adult patients with CSH.
- Review of clinical files from the Department of Neurosurgery, Medical Academy of Lódź.
Main Results:
- 14 patients (10.7%) presented with sudden onset, mimicking cerebral stroke.
- 50% of patients exhibited symptoms of increased intracranial pressure (ICP).
- Focal neurological deficits were more frequent in patients over 40 years old, with homolateral signs in 13%.
Conclusions:
- CSH can present atypically, sometimes resembling a stroke.
- Despite advances in imaging, CSH may be overlooked if not considered as a potential intracranial space-occupying lesion.
Abstract:
To assess the clinical manifestation of chronic subdural haematoma (CSH) the authors retrospectively analysed the files of 131 adult patients treated in the Department of Neurosurgery Medical Academy of Lódź. In 14 patients the illness had a sudden onset, suggesting cerebral stroke. 50% of patients had symptoms of raised ICP, there were no differences between young and older patients. In patients older than 40 years focal neurological deficits were more frequent, and in 13% of them focal signs were homolateral to CSH. In 9 patients the lesion produced symptoms of transtentorial herniation within a very short period. The authors think that despite the great progress in neuroradiology and neurosurgery, the condition may still be overlooked if the clinical picture does not suggest an intracranial space-occupying growth.