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Abstract
Objective
Chronic subdural hematoma (cSDH) is one of the most common types of intracranial hemorrhage. As the number of elderly people is increasing, the incidence of cSDH is growing. Therefore, we analyzed clinical manifestation of the cSDH.
Methods
The authors retrospectively reviewed the data of the 169 patients of cSDH who were 65 years or older and undergone burr-hole trephination and closed drainage in our hospital between January 2008 and December 2012. Patients were divided into two subgroups; group A: young than 75 years, group B: 75 years or older. We analyzed the differences of clinical aspects and surgical results in both groups.
Results
Proportion of male patients in group A (83.8%) was higher than in group B (58.4%) with statistical significance (p=0.003). Alteration of consciousness as an initial symptom was significantly more frequent in group A (17.5%) than in group B (4.4%)(p=0.006). Postoperatively, 164 of 169 patients (97%) were free from symptom within three days in both groups. Pneumonia followed the surgery in three patients (one in group A and two in group B).
References
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TABLE 1.
General characteristics and etiology
| Group A | Group B | Total | p-value∗ | |
|---|---|---|---|---|
| Number of patient | 80 | 89 | 169 | |
| Age (years) | ||||
| Mean | 69.9±2.9 | 79.8±3.9 | 75.2 | |
| Range | 65–74 | 75–92 | 65–92 | |
| Sex (%) | 0.003 | |||
| Male | 67 (83.8) | 52 (58.4) | 119 (70.4) | |
| Female | 13 (16.2) | 37 (41.6) | 50 (29.6) | |
| Side (%) | ||||
| Left | 40 (50.0) | 25 (28.0) | 65 (38.4) | ＞0.05 |
| Right | 24 (30.0) | 32 (35.9) | 56 (33.1) | ＞0.05 |
| Both | 16 (20.0) | 32 (35.9) | 48 (28.4) | ＞0.05 |
| Preoperative medical history (%) | ||||
| Hypertension | 39 (48.7) | 50 (56.1) | 89 (52.6) | ＞0.05 |
| Diabetes mellitus | 17 (21.2) | 18 (20.2) | 35 (20.7) | ＞0.05 |
| Cerebral infarction | 9 (11.2) | 7 (7.8) | 16 (9.4) | ＞0.05 |
| Ischemic heart disease | 7 (8.7) | 3 (3.3) | 10 (5.9) | ＞0.05 |
| Incidence of trauma history (%) | 46 (57.5) | 46 (51.6) | 92 (54.0) | ＞0.05 |
| Oral anticoagulation (%) | 4 (5.0) | 3 (3.3) | 7 (4.1) | ＞0.05 |
| Oral antiplatelet (%) | 14 (17.5) | 8 (8.9) | 22 (13.0) | ＞0.05 |
TABLE 2.
Clinical symptoms and signs
| Group A | Group B | Total | p-value∗ | |
|---|---|---|---|---|
| Hemiparesis (%) | 38 (47.5) | 43 (48.3) | 81 (47.9) | 0.955 |
| Headache (%) | 25 (31.2) | 32 (35.9) | 57 (33.7) | 0.518 |
| Change of consciousness (%) | 14 (17.5) | 4 (4.4) | 18 (10.6) | 0.006 |
| Speech disturbance (%) | 5 (6.2) | 3 (3.3) | 8 (4.7) | 0.979 |
| Dizziness (%) | 3 (3.7) | 2 (2.2) | 5 (2.9) | 0.565 |
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