[Chronic subdural hematoma. A frequently suspected diagnosis]

A retrospective investigation was undertaken in which the clinical picture in 43 patients in whom chronic subdural haematoma (CSH) was diagnosed during a period of 11 years in a large central hospital were compared with the clinical picture in 97 patients referred for neurological assessment on account of suspected CSH during a period of three years. Thirteen out of the 97 patients referred with suspected CSH had the disease. All of the patients with CSH had focal neurological symptoms or complained of headache. None presented only mental symptoms and/or impaired consciousness. On this basis, the diagnosis could have been repudiated in 30% of the patients referred who presented neither focal neurological symptoms nor complained of headache. Information about previous head-injury was not found to be of any significant value for the diagnosis. Probably, no or only few cases of CHS are overlooked.