[Chronic subdural hematoma in aged patients. Diagnostic problems]

The history, clinical features, laboratory tests and admission circumstances were analysed retrospectively in 14 patients, aged 60 to 87 years, who were found to have a chronic subdural haematoma. Typical clinical features consisted of dominant psychiatric disorders, slow progression and frequently only traces of neurological signs. In only four patients was headache the initial symptom. Delay in diagnosis and treatment worsened the prognosis. Several factors account for the nonspecific signs and symptoms: diffuse cerebral atrophy, dementia of a degenerative or vascular nature, and cerebral decompensation. Computed tomography immediately after a trauma may be negative.