Falcine and Tentorial Subdural Hematomas May Not Routinely Require Transfer to a Tertiary Care Center

Area of Science:

• Neurosurgery
• Trauma Surgery
• Neurology

Background:

• Subdural hematomas (SDH) often necessitate transfer to tertiary care centers.
• While convexity SDH is well-studied, falcine and tentorial SDH characteristics remain less understood.

Purpose of the Study:

• To delineate the specific features and outcomes of isolated falcine and tentorial SDH.
• To evaluate the necessity of tertiary care transfer for these SDH subtypes.

Main Methods:

• Retrospective review of adult patients with acute SDH transferred to a tertiary care center.
• Analysis of clinical and radiographic findings, treatment, length of stay (LOS), and patient outcomes.
• Univariate analysis comparing isolated falcine/tentorial SDH with convexity SDH.

Main Results:

• Twenty-seven patients had isolated falcine or tentorial SDH, with a traumatic etiology in 23.
• Falcine/tentorial SDH patients did not require surgery or intubation, were younger, and had higher admission Glasgow Coma Scale scores.
• These patients experienced shorter intensive care unit LOS and a 100% favorable outcome, contrasting with 68% for convexity SDH.

Conclusions:

• Isolated tentorial/falcine SDH without neurological deficits is a benign condition.
• Surgical intervention is unnecessary, LOS is short, and outcomes are favorable for these patients.
• Tertiary care transfer may not be routinely indicated for isolated tentorial/falcine SDH in the absence of complicating factors.