[Psychiatric symptoms of patients with chronic subdural hematoma]

Thirty-two cases with chronic subdural hematoma in adults were analyzed from two standpoints; one is the characteristics of pre- and post-operative psychiatric symptoms, the other is the common factors in patients with post-operative psychiatric symptoms. The average age of subjects was 55.4 years, and psychiatric symptoms were noticed in 18 cases (56%). Main pre-operative psychiatric symptoms were disorders of intellectual capacity including memory and orientation disturbance and were able to be classified into amnestic syndrome and dementia according to DSM-3. Outcome in amnestic group was good in contrast to that in dementia group mostly complicated by post-operative psychiatric symptoms. Post-operative psychiatric symptoms were seen in 6 cases. The average age of these cases was 68.2 years which was higher than that of asymptomatic group. And these were classified as dementia according to DSM-3. Common factors in these 6 cases were as follows: Accompanied by marked pre-operative psychiatric symptoms. High age. Complicated by post-operative subdural fluid collection with certain mass effects. Long period from head injury to operation. Accompanied by other complications such as cirrhosis of liver and hypertension. Subdural fluid collection following surgery is a problem under discussion. We obtained favorable results by subdural-peritoneal shunt.