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Related Experiment Video

Updated: Dec 26, 2025

A Low Mortality Rat Model to Assess Delayed Cerebral Vasospasm After Experimental Subarachnoid Hemorrhage
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Long-term excess mortality after chronic subdural hematoma.

Minna Rauhala1, Pauli Helén2, Karri Seppä3

  • 1Department of Neurosurgery, Tampere University Hospital and Tampere University, Tampere, Finland. minna.j.rauhala@pshp.fi.

Acta Neurochirurgica
|March 9, 2020
PubMed
Summary

Patients with chronic subdural hematoma (CSDH) face ongoing excess mortality for up to 20 years post-diagnosis. Factors like poor functional status and alcohol abuse significantly increase this risk, with dementia being a leading cause of death.

Keywords:
Causes of deathMortality, excessSubdural hematoma, chronicSurvival

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Area of Science:

  • Neurosurgery
  • Gerontology
  • Public Health

Background:

  • Chronic subdural hematoma (CSDH) is a significant neurological condition in older adults.
  • Understanding long-term mortality risks and causes of death is crucial for patient management and prognosis.

Purpose of the Study:

  • To evaluate the long-term excess mortality associated with chronic subdural hematoma (CSDH).
  • To identify specific causes of death and risk factors contributing to increased mortality in CSDH patients.

Main Methods:

  • Retrospective analysis of 1133 adult CSDH patients (1990-2015) with follow-up until 2017.
  • Comparison of mortality rates and causes of death against a matched general population and control group.
  • Estimation of cumulative relative survival ratios and relative excess risks (RER) of death.

Main Results:

  • Significant excess mortality observed up to 20 years post-CSDH diagnosis (20-year cumulative excess mortality at 48%).
  • Factors associated with increased mortality include poor modified Rankin score, alcohol abuse, warfarin use, advanced age (≥80), non-operative treatment, and non-traumatic etiology.
  • Dementia was the most frequent cause of death in CSDH patients (21%) compared to controls (15%).

Conclusions:

  • CSDH patients experience persistent excess mortality, influenced by patient-related factors rather than hematoma characteristics.
  • There is a notably increased risk of dementia-related mortality among individuals with CSDH.
  • Prognosis is strongly linked to pre-existing conditions and functional status at diagnosis and discharge.