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The cognitive status of chronic subdural hematoma patients after treatment: an exploratory study
Jurre Blaauw1,2, Heleen M den Hertog3, Dana C Holl4,5
1Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands. j.blaauw02@umcg.nl.
Insights
Cognitive impairment is common in chronic subdural hematoma (CSDH) patients after treatment. Three months post-treatment, CSDH patients showed significantly lower cognitive scores than healthy individuals.
Area of Science:
- Neurology
- Neuroscience
- Geriatrics
Background:
- Chronic subdural hematoma (CSDH) is a prevalent neurological condition, particularly in the elderly.
- Cognitive impairment is frequently observed in CSDH patients at the time of diagnosis.
- The long-term cognitive trajectory following CSDH treatment remains largely unexplored.
Purpose of the Study:
- To investigate the cognitive status of patients diagnosed with chronic subdural hematoma (CSDH) three months after surgical treatment.
- To compare the cognitive performance of treated CSDH patients with that of age- and sex-matched healthy controls.
Main Methods:
- An exploratory study involving 56 CSDH patients and 60 healthy controls.
- Cognitive function was assessed using the Telephonic Interview of Cognitive Status-modified (TICS-m) questionnaire.
- Testing occurred a median of 93 days post-treatment for CSDH patients.
Main Results:
- Treated CSDH patients exhibited significantly lower TICS-m scores compared to healthy controls, even after adjusting for age and sex (p < 0.001).
- The mean TICS-m score for CSDH patients was 34.6 (95% CI: 33.6-35.9) versus 39.6 (95% CI: 38.5-40.7) for controls.
- Over half (54%) of CSDH patients demonstrated cognitive scores indicative of impairment at the 3-month follow-up.
Conclusions:
- A substantial proportion of chronic subdural hematoma patients experience persistent cognitive deficits three months after treatment.
- These findings highlight the need for heightened clinical awareness regarding post-CSDH cognitive impairment.
- Further research is essential to understand and address the cognitive sequelae of CSDH.
Objective:
Chronic subdural hematoma (CSDH) is a common neurological condition, often affecting the elderly. Cognitive impairment is frequently observed at presentation. However, the course and longer term aspects of the cognitive status of CSDH patients are unknown. In this study, we aim to explore the cognitive status of CSDH patients after treatment.
Methods:
An exploratory study in which CSDH patients were assessed 3 months after treatment and compared to healthy controls. A total of 56 CSDH patients (age 72.1 SD ± 10.8 years with 43 [77%] males) and 60 healthy controls were included (age 67.5 ± SD 4.8 with 34 [57%] males). Cognitive testing was performed using the Telephonic Interview of Cognitive Status-modified (TICS-m), a 12-item questionnaire in which a total of 50 points can be obtained on several cognitive domains.
Results:
Median time between treatment and cognitive testing was 93 days (range 76-139). TICS-m scores of CSDH patients were significantly lower than healthy controls, after adjusting for age and sex: mean score 34.6 (95% CI: 33.6-35.9) vs. 39.6 (95% CI: 38.5-40.7), p value < 0.001. More than half (54%) of CSDH patients have cognitive scores at follow-up that correspond with cognitive impairment.
Conclusion:
A large number of CSDH patients show significantly worse cognitive status 3 months after treatment compared to healthy controls. This finding underlines the importance of increased awareness for impaired cognition after CSDH. Further research on this topic is warranted.
