Journal List > J Korean Neurotraumatol Soc > v.7(2) > 1084105

J Korean Neurotraumatol Soc. 2011 Oct;7(2):83-87. Korean.
Published online October 31, 2011.
Copyright © 2011 Korean Neurotraumatology Society
Age-Specific Characteristics in Chronic Subdural Hematoma Patients
Seung-Hwan Lee, MD, Sung-Kon Ha, MD, Jong Hyun Kim, MD, Joo-Han Kim, MD, Taek-Hyun Kwon, MD and Yun Kwan Park, MD
Department of Neurosurgery, Guro Hospital, Korea University College of Medicine, Seoul, Korea.

Address for correspondence: Jong Hyun Kim, MD. Department of Neurosurgery, Guro Hospital, Korea University College of Medicine, 97 Gurodong-gil, Guro-gu, Seoul 152-703, Korea. Tel: +82-2-2626-3096, Fax: +82-2-863-1684, Email:
Received August 03, 2011; Revised August 25, 2011; Accepted August 25, 2011.



It is well known that chronic subdural hematoma (CSDH) is relatively common in geriatric patients. However, frequently, CSDH can also develop in younger patients. We hypothesized that some clinical features may be different according to the age groups.


Total one-hundred thirty seven surgically treated CSDH patients from January 2006 to April 2011 were included. We divided patients into three sub-group by age (young, average and old). We investigated several risk factors, preoperative and postoperative CT findings of each groups.


Hypertension, head trauma, arachnoid cyst and spontaneous intracranial hypotension were significantly associated with young age group compared to other groups. The recurrence rate of CSDH was higher in old age group with preoperative high density hematoma and postoperative pneumocephalus.


In this study, intracranial underlying diseases were relatively common in young age group. Old age group showed higher incidence of recurrence, preoperative mixed density and postoperative pneumocephalus on CT.

Keywords: Chronic subdural hematoma; Age Groups; Risk factors; Recurrence; Pneumocephalus


Age distribution in chronic subdural hematoma patients.
Click for larger image


Correlation analysis between age-subgroups and risk factors in chronic subdural hematoma patients
Click for larger image

Correlation analysis between age-subgroups and CT findings in chronic subdural hematoma patients
Click for larger image


The authors have no financial conflicts of interest.

1. Adhiyaman V, Asghar M, Ganeshram KN, Bhowmick BK. Chronic subdural haematoma in the elderly. Postgrad Med J 2002;78:71–75.
2. Baechli H, Nordmann A, Bucher HC, Gratzl O. Demographics and prevalent risk factors of chronic subdural haematoma: results of a large single-center cohort study. Neurosurg Rev 2004;27:263–266.
3. Domenicucci M, Russo N, Giugni E, Pierallini A. Relationship between supratentorial arachnoid cyst and chronic subdural hematoma: neuroradiological evidence and surgical treatment. J Neurosurg 2009;110:1250–1255.
4. Ferrante E, Arpino I, Citterio A, Wetzl R, Savino A. Epidural blood patch in Trendelenburg position pre-medicated with acetazolamide to treat spontaneous intracranial hypotension. Eur J Neurol 2010;17:715–719.
5. Hishikawa T, Chikama M, Tsuboi M, Yabuno N. [Two cases of symptomatic arachnoid cysts in elderly patients--a comparison and analysis with child cases]. No Shinkei Geka 2002;30:959–965.
6. Jolobe OM. Chronic subdural haematoma in the elderly. J R Soc Med 2002;95:427–428.
7. Kajs-Wyllie M. Antihypertensive treatment for the neurological patient: a nursing challenge. J Neurosci Nurs 1999;31:142–151.
8. Ko BS, Lee JK, Seo BR, Moon SJ, Kim JH, Kim SH. Clinical analysis of risk factors related to recurrent chronic subdural hematoma. J Korean Neurosurg Soc 2008;43:11–15.
9. Krupa M, Moskała M, Składzień T, Grzywna E. [Influence of anticoagulants on the appearance of chronic subdural hematoma]. Przegl Lek 2009;66:403–405.
10. Le TH, Gean AD. Neuroimaging of traumatic brain injury. Mt Sinai J Med 2009;76:145–162.
11. Leung GK, Fan YW. Chronic subdural haematoma and arachnoid cyst in autosomal dominant polycystic kidney disease (ADPKD). J Clin Neurosci 2005;12:817–819.
12. Liliang PC, Tsai YD, Liang CL, Lee TC, Chen HJ. Chronic subdural haematoma in young and extremely aged adults: a comparative study of two age groups. Injury 2002;33:345–348.
13. Lindvall P, Koskinen LO. Anticoagulants and antiplatelet agents and the risk of development and recurrence of chronic subdural haematomas. J Clin Neurosci 2009;16:1287–1290.
14. Liu Y, Gong J, Li F, Wang H, Zhu S, Wu C. Traumatic subdural hydroma: clinical characteristics and classification. Injury 2009;40:968–972.
15. Mori K, Maeda M. Surgical treatment of chronic subdural hematoma in 500 consecutive cases: clinical characteristics, surgical outcome, complications, and recurrence rate. Neurol Med Chir (Tokyo) 2001;41:371–381.
16. Onwuchekwa CR, Onwuchekwa AC. The role of computed tomography in the diagnostic work-up of headache patients in Nigeria. Headache 2010;50:1346–1352.
17. Ramesha KN, Chandrashekaran K, Thomas SV. Cerebrospinal fluid hypovolemia syndrome with benign course. Ann Indian Acad Neurol 2010;13:293–296.
18. Senturk S, Guzel A, Bilici A, Takmaz I, Guzel E, Aluclu MU, et al. CT and MR imaging of chronic subdural hematomas: a comparative study. Swiss Med Wkly 2010;140:335–340.
19. Shaikh N, Masood I, Hanssens Y, Louon A, Hafiz A. Tension pneumocephalus as complication of burr-hole drainage of chronic subdural hematoma: a case report. Surg Neurol Int 2010;1
20. Sharma BS, Tewari MK, Khosla VK, Pathak A, Kak VK. Tension pneumocephalus following evacuation of chronic subdural haematoma. Br J Neurosurg 1989;3:381–387.
21. Torihashi K, Sadamasa N, Yoshida K, Narumi O, Chin M, Yamagata S. Independent predictors for recurrence of chronic subdural hematoma: a review of 343 consecutive surgical cases. Neurosurgery 2008;63:1125–1129.
discussion 1129.