Related Experiment Video

Updated: Nov 29, 2025

Minimally Invasive Endoscopic Intracerebral Hemorrhage Evacuation
09:01

Minimally Invasive Endoscopic Intracerebral Hemorrhage Evacuation

Published on: October 15, 2021

8.2K

Surgical Management of Chronic Subdural Hematoma in Older Adults: A Systematic Review

Nathan A Shlobin1, Jayanidhi Kedda2, Danielle Wishart1

  • 1Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois.

The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
|November 21, 2020
PubMed

Insights

Surgery for chronic subdural hematoma (cSDH) in older adults offers favorable outcomes comparable to younger patients. However, careful consideration of mortality risk and medication use is crucial for optimal management.

Area of Science:

  • Neurosurgery
  • Geriatric Medicine
  • Neurology

Background:

  • Chronic subdural hematoma (cSDH) is a common intracranial hemorrhage in the elderly, with treatment strategies often debated.
  • Optimal surgical thresholds and management considerations for cSDH in older adults require further evidence synthesis.

Purpose of the Study:

  • To systematically review surgical management of cSDH in individuals aged 65 and older.
  • To identify surgical thresholds, characterize outcomes, and delineate critical considerations for cSDH in older adults.

Main Methods:

  • A systematic review was conducted using PubMed, Embase, and Scopus databases.
  • Articles were screened for full-text review based on a priori criteria, analyzing data on study design, population, interventions, and outcomes.

Main Results:

  • Twenty-one articles were included from 1473 initial results.
  • Surgery for symptomatic cSDH demonstrated superiority over conservative management with equivalent neurologic outcomes and complication rates.
  • Older adults showed similar recurrence and reoperation rates to younger patients, though some studies indicated higher mortality.

Conclusions:

  • Surgical management of cSDH in older adults yields favorable neurologic outcomes with no increased risk of complications, recurrence, or reoperation compared to younger individuals.
  • Older adults may face an elevated risk of mortality post-surgery for cSDH.
  • The use of anticoagulant or antiplatelet agents in older adults with cSDH warrants careful assessment for optimal patient management.
Abstract

Keywords:
Burr holeChronic subdural hematomaCraniotomyNeurosurgeryOlder adultsSubdural hematoma

More Related Videos

Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms11:58

Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms

Published on: August 11, 2015

15.8K
Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations14:58

Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations

Published on: October 20, 2017

10.0K

Related Concept Videos

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption01:22

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption

As individuals age, their body's physiology evolves, affecting drug pharmacokinetics. The most apparent changes occur in the gastrointestinal tract, where an increase in gastric pH, a delay in gastric emptying, and a reduction in gastrointestinal motility are observed. Remarkably, these changes do not substantially modify the absorption of orally administered drugs, particularly those absorbed via passive diffusion.Transdermal drug delivery emerges as a highly viable method for older adults due...
106
Aneurysm III: Interprofessional Care01:26

Aneurysm III: Interprofessional Care

Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
130
Pharmacodynamics in Geriatric Patients: Effects of Age01:27

Pharmacodynamics in Geriatric Patients: Effects of Age

Age-related pharmacokinetic changes are extensively documented, but understanding age-related pharmacodynamic alterations is relatively limited. This knowledge gap can be partly attributed to the complexity of developing appropriate measures of drug responses compared to bioanalytical methods for determining drug concentrations.Most information regarding age-related differences in human pharmacodynamics originates from cross-sectional studies. However, these studies assume that observed mean...
104