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Related Experiment Video

Updated: Jul 12, 2025

Pre-Chiasmatic, Single Injection of Autologous Blood to Induce Experimental Subarachnoid Hemorrhage in a Rat Model

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Classification of subdural hematomas: proposal for a new system improving the ICD Coding Tools.

Anne-Marie Langlois¹, Charles J Touchette¹, David Mathieu¹

¹Division of Neurosurgery, Department of Surgery, Université de Sherbrooke, Sherbrooke, QC, Canada.

Frontiers in Neurology

|October 27, 2023

Summary

The International Statistical Classification of Diseases (ICD) coding system struggles to classify membrane-associated subdural hematoma (SDH). This study proposes a new SDH classification system to improve accuracy for clinical management and prognosis.

Keywords:

ICD chronic subdural hematoma intracranial hemorrhage subdural hematoma trauma

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Published on: August 30, 2020

Area of Science:

Neurology
Medical Informatics
Pathology

Background:

The International Statistical Classification of Diseases (ICD) categorizes subdural hematoma (SDH) as traumatic or non-traumatic.
Clinically, SDH is often described by its chronicity (acute or chronic).
Current ICD coding may not fully capture the nuances of SDH presentation relevant to patient care.

Purpose of the Study:

To evaluate the ICD Coding Tools' ability to represent clinical SDH terminology.
To propose an enhanced SDH classification for improved administrative, statistical, and research utility.
To better align coding with clinical descriptions impacting management and prognosis.

Main Methods:

Retrospective analysis of 277 patients with ICD-coded SDH.
Qualitative chart review to identify clinical elements (chronicity, etiology, symptoms).
Expert investigator meeting to develop a new SDH classification system.
Reclassification of cases based on the proposed system and imaging review.

Main Results:

The ICD system accurately codes traumatic acute SDH (taSDH) and non-traumatic acute SDH (ntaSDH).
The ICD system lacks specificity for membrane-associated SDH (mSDH).
A new classification distinguishing acute SDH (aSDH) from membrane-associated SDH (mSDH) was developed, with further subcategories for mSDH (acute on chronic, subacute, chronic).

Conclusions:

The proposed SDH classification system better captures chronicity and etiology.
This improved classification is expected to enhance management and prognosis assessment.
The study highlights limitations in current ICD coding for specific SDH types, particularly mSDH.