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Chronic Subdural Haematoma in the Elderly: Is It Time for a New Paradigm in Management?

J Shapey1, L J Glancz2, P M Brennan3

  • 1National Hospital for Neurology and Neurosurgeon, Queen Square, London, UK.

Current Geriatrics Reports
|May 24, 2016
PubMed

Insights

Chronic subdural hematoma (CSDH) care for elderly patients needs better evidence. An integrated, non-surgical approach may improve outcomes and reduce CSDH recurrence.

Area of Science:

  • Neurology
  • Neurosurgery
  • Geriatrics

Background:

  • Chronic subdural hematoma (CSDH) is a frequent neurological condition, particularly in the elderly population.
  • Current treatment strategies for CSDH lack a robust evidence base, leading to uncertainty in optimal management.
  • Peri-operative and operative care are critical, but non-surgical aspects also significantly influence patient outcomes and recurrence rates.

Purpose of the Study:

  • To review existing literature on peri-operative and operative care for CSDH patients.
  • To emphasize the importance of non-surgical management factors affecting CSDH outcomes and recurrence.
  • To propose an integrated care model for CSDH management.

Main Methods:

  • Literature review focusing on peri-operative and operative care for CSDH.
  • Analysis of non-surgical factors impacting patient outcomes and recurrence.
  • Comparative approach to care models, drawing parallels with fragility fracture management.

Main Results:

  • The evidence base for optimal CSDH treatment is currently limited.
  • Non-surgical elements of care play a crucial role in patient recovery and preventing CSDH recurrence.
  • An integrated care strategy, mirroring that used for fragility fractures, shows promise.

Conclusions:

  • Improved evidence is needed to guide CSDH treatment strategies.
  • An integrated, multidisciplinary approach to CSDH care, including non-surgical aspects, is recommended.
  • This integrated model may enhance patient care and reduce CSDH recurrence, particularly in elderly individuals.

Keywords:
CSDHChronic subdural haematomaElderlyOutcomesPeri-operative care

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