Chronic subdural haematomas are more common on the left than on the right

M R MacFarlane1, Y Weerakkody, Y Kathiravel

  • 1Department of Neurosurgery, Christchurch Hospital, Private Bag 4710, Christchurch, New Zealand. martin.macfarlane@cdhb.govt.nz

Insights

This study found chronic subdural hematomas (CSDHs) are more common on the left side. This research analyzed 450 subdural hematomas (SDHs) in 413 patients, noting a left-sided prevalence in CSDHs.

Area of Science:

  • Neurosurgery
  • Neurology
  • Medical Research

Background:

  • Subdural hematomas (SDHs), particularly chronic subdural hematomas (CSDHs), are frequent in neurosurgical practice.
  • While etiology, presentation, management, and prognosis are documented, laterality (side prevalence) of SDHs is less explored.
  • Existing literature lacks comprehensive data on the side distribution of acute, subacute, and chronic subdural hematomas.

Purpose of the Study:

  • To analyze the laterality of subdural hematomas (SDHs) in patients presenting to a neurosurgical service.
  • To investigate if there is a significant difference in the prevalence of SDHs between the left and right sides, specifically for chronic subdural hematomas (CSDHs).

Main Methods:

  • Retrospective analysis of all patients with SDHs presenting to Christchurch Hospital's Neurosurgical Service from January 1996 to June 2006.
  • Inclusion of both surgically treated and conservatively managed patients.
  • Data collected included patient demographics, SDH type (acute, subacute, chronic), and laterality.

Main Results:

  • A total of 413 patients presented with 450 SDHs: 150 acute (33.3%), 38 subacute (8.4%), and 262 chronic (58.2%).
  • Male predominance was observed across all SDH subgroups (67% male, 33% female).
  • While acute and subacute SDHs were unilaterally distributed, chronic subdural hematomas (CSDHs) showed a statistically significant higher prevalence on the left side (57.2%) compared to the right (42.7%; p=0.0345).

Conclusions:

  • Chronic subdural hematomas (CSDHs) exhibit a significant left-sided prevalence.
  • The findings suggest potential underlying factors contributing to the increased diagnosis of left-sided CSDHs.
  • Further research is warranted to explore the reasons behind this observed laterality in CSDHs.

Related Concept Videos

Hemorrhagic Stroke l: Introduction01:17

Hemorrhagic Stroke l: Introduction

A hemorrhagic stroke is an acute neurological event that occurs when a weakened cerebral blood vessel ruptures, allowing blood to accumulate within or around the brain. The sudden release of blood forms a focal hematoma that increases intracranial pressure, displaces neural tissue, and can obstruct cerebrospinal fluid pathways. These effects may be compounded by intraventricular extension of the hemorrhage, cerebral edema, or compression of adjacent structures, all of which contribute to...
Lateralization01:28

Lateralization

Brain lateralization refers to the division of mental processes and functions between the two hemispheres of the brain, a phenomenon that optimizes neural efficiency and underpins complex abilities in humans. This specialization allows each hemisphere to perform tasks where it has a comparative advantage, facilitating more refined cognitive capabilities across different domains.
Hemorrhagic Stroke ll: Pathophysiology01:29

Hemorrhagic Stroke ll: Pathophysiology

A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
Cerebral Hemispheres01:05

Cerebral Hemispheres

The human brain, a complex organ, is functionally divided into two cerebral hemispheres—left and right. These hemispheres are interconnected by a structure of paramount importance, the corpus callosum. This substantial bundle of neural fibers is not just a bridge between the hemispheres but a crucial element for the brain's comprehensive functioning. It enables efficient communication between the two hemispheres, allowing each side of the brain to control and receive sensory and motor...
Increased Intracranial Pressure l: Introduction01:14

Increased Intracranial Pressure l: Introduction

Intracranial hypertension is a sustained elevation of intracranial pressure (ICP) above 22 mm Hg. In supine adults, normal ICP is ~7–15 mm Hg.The rigid, nonexpandable cranium contains three components—brain tissue, blood, and cerebrospinal fluid (CSF)—that total ~1,700 mL in a typical adult: 1,400 mL brain (~80%), 150 mL blood (~10%), and 150 mL CSF (~10%). According to the Monro–Kellie doctrine, total intracranial volume is effectively fixed. When one component expands, CSF and venous blood...
Brain Abscess l: Introduction01:26

Brain Abscess l: Introduction

A brain abscess is a focal, intracerebral infection characterized by a localized collection of pus within the brain parenchyma, resulting from microbial invasion and the body’s inflammatory response. It progresses through stages: early and late cerebritis, followed by early and late capsule formation, reflecting tissue destruction, immune response, and eventual encapsulation.Etiology and PathogenesisCausative organisms vary with source and host factors, often involving polymicrobial infections,...