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Chronic subdural hematoma - review article.
Rozhledy V Chirurgii : Mesicnik Ceskoslovenske Chirurgicke Spolecnosti
|November 17, 2018
Summary
Chronic subdural hematoma (ChSDH) management is crucial for general surgeons. Asymptomatic cases may be monitored, while symptomatic patients require surgical intervention, often starting with burr hole evacuation.
Area of Science:
- Neurosurgery
- General Surgery
Background:
- Chronic subdural hematoma (ChSDH) is a subdural blood collection exceeding 21 days.
- ChSDH is frequently diagnosed in regional hospitals, necessitating basic knowledge for general surgeons.
Purpose of the Study:
- To summarize key information on ChSDH.
- To present simple clinical management guidelines for ChSDH.
Main Methods:
- Management strategies include watchful waiting for asymptomatic cases.
- Symptomatic ChSDH is treated surgically, often with burr hole evacuation under local anesthesia.
- Recurrent or complex cases may require reoperation or craniotomy.
Main Results:
- Asymptomatic ChSDH can be managed conservatively.
- Surgical evacuation is effective for symptomatic ChSDH.
- Burr hole evacuation is a well-tolerated initial surgical approach, especially for elderly patients.
Conclusions:
- ChSDH is a common condition requiring general surgical awareness.
- Clinical presentations include headache, confusion, hemiparesis, and aphasia.
- Referral to experienced neurosurgical departments is recommended for all ChSDH patients.
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