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[Chronic subdural hematoma in aged patients. Diagnostic problems].
E Windhager1, F Reisecker, H D Huber
1Abteilung für Neurologische-Psychiatrische Gerontologie, Wagner-Jauregg-Krankenhauses Linz sowie Interne Abteilung des Landeskrankenhauses Enns.
Deutsche Medizinische Wochenschrift (1946)
|June 3, 1988
Summary
Chronic subdural hematoma in elderly patients often presents with psychiatric disorders and subtle neurological signs, delaying diagnosis. Prompt recognition and treatment are crucial for better outcomes in this vulnerable population.
Area of Science:
- Neurology
- Geriatrics
- Neurosurgery
Background:
- Chronic subdural hematoma (CSH) is a significant concern in the elderly.
- Diagnosis can be challenging due to atypical presentations.
Purpose of the Study:
- To analyze the clinical features, diagnostic challenges, and outcomes of CSH in older adults.
- To highlight factors contributing to delayed diagnosis and their impact on prognosis.
Main Methods:
- Retrospective analysis of 14 patients aged 60-87 with CSH.
- Review of patient history, clinical presentation, laboratory tests, and admission circumstances.
Main Results:
- Typical features included prominent psychiatric disorders, slow progression, and minimal neurological signs.
- Headache was the initial symptom in only four patients.
- Computed tomography scans immediately post-trauma could be negative.
Conclusions:
- Nonspecific signs and symptoms in the elderly are often due to cerebral atrophy, dementia, or decompensation.
- Delayed diagnosis and treatment significantly worsen the prognosis for chronic subdural hematoma.