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Chronic subdural hematoma in patients over 90 years old in a super-aged society

Sadaharu Tabuchi1, Mitsutoshi Kadowaki1

  • 1Department of Neurosurgery, Tottori Prefectural Central Hospital, Tottori, Japan.

Journal of Clinical Medicine Research
|August 12, 2014
PubMed

Insights

Surgery for chronic subdural hematoma (CSDH) is safe and effective for patients over 90 years old. Pre-illness physical status is key for successful surgical outcomes in this super-aged population.

Area of Science:

  • Neurosurgery
  • Geriatric Medicine
  • Neurology

Background:

  • Chronic subdural hematoma (CSDH) is a common neurosurgical condition, particularly in the elderly.
  • The incidence of CSDH is increasing due to a growing aged population.
  • Limited research exists on CSDH management in super-aged individuals (over 90 years old).

Purpose of the Study:

  • To evaluate the safety and efficacy of surgical interventions for chronic subdural hematoma (CSDH) in patients aged 90 years and older.
  • To identify factors influencing surgical outcomes in this specific demographic.

Main Methods:

  • Retrospective review of 20 patients over 90 years old diagnosed with CSDH.
  • Comparison between surgical (burr-hole with drain) and conservative treatment groups.
  • Neurological status assessed using the modified Rankin Scale pre-CSDH, at admission, and at discharge/1 month post-referral.

Main Results:

  • The mean age of patients was 92.6 years.
  • Surgical intervention in CSDH patients over 90 years old led to significant neurological improvement (P < 0.01).
  • 66.7% of surgically treated patients could return home post-discharge, with no significant perioperative complications.

Conclusions:

  • Surgical treatment for CSDH is recommended for super-aged patients (over 90) with a fair physical status.
  • Pre-illness functional status is a critical determinant for operative indication and postoperative outcomes in this population.
Abstract

Keywords:
90 years oldAgedChronic subdural hematomaElderlySurgical treatment

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