[Chronic subdural haematomas in very elderly patients]

Area of Science:

• Neurosurgery
• Geriatric Medicine
• Neurology

Background:

• Chronic subdural hematoma (CSDH) is a frequent neurosurgical condition, particularly in elderly populations.
• This study focuses on analyzing CSDH in patients aged 85 and above.

Purpose of the Study:

• To analyze demographic, clinical, and radiological findings in elderly patients (over 85 years) with CSDH.
• To evaluate surgical outcomes, including complications, recurrence, and mortality, in this specific age group.

Main Methods:

• Retrospective review of 200 patients over 85 years with CSDH treated between April 1986 and November 2015.
• Data collected included patient characteristics, comorbidities, risk factors, imaging details, and surgical outcomes.
• Analysis of factors such as gender, clinical grade, antithrombotic therapy, and hematoma characteristics in relation to mortality and recurrence.

Main Results:

• The study included 200 patients (mean age 88.5 years), with a 1:1.1 male:female ratio.
• 57% reported a history of injury; 35.5% were on anti-platelet or anticoagulant therapy.
• Behavioral disturbance was the most common symptom (41%). Postoperative complications occurred in 29% of cases, with 29% recurrence rate.
• Preoperative Markwalder grade significantly correlated with recurrence and mortality (P<.0001).

Conclusions:

• CSDH is highly prevalent in the very elderly population.
• Behavioral disturbances and neurological deficits are common initial symptoms.
• Preoperative neurological status is a critical predictor of recurrence and mortality in elderly CSDH patients.