Spectrum of Chronic Subdural Haematoma in Elderly Patients Managed at a Single Neurosurgical Unit
Author(s):
Sonwabile Gonya1*, Basil Enicker2
and Mduduzi Brian Msomi2
Introduction: Chronic subdural haematoma (CSDH) refers to the accumulation of liquefied blood between the dura mater and arachnoid, presenting as an encapsulated collection. Clinical manifestations of CSDH vary.
Objectives: This study aims to investigate the spectrum, demographic patterns, risk factors, clinical presentation, imaging characteristics, surgical management, and outcomes of surgical treatment for CSDH.
Study Methodology: A retrospective analysis was conducted on elderly patients diagnosed with CSDH who underwent surgical treatment between January 2016 and September 2022.
Results: The study sample comprised 135 elderly patients, with 81 (60%) males and 54 (40%) females, resulting in a male-to-female ratio of 1.5:1. The age range was 65 to 90 years, with an average age of 72.6 years.
Non-traumatic CSDH was observed in 58% of patients, with an average symptom duration of 14.4 days. Headache was reported by 134 patients (99%), while 102 (76%) had hypertension and focal neurological deficits. Altered consciousness was present in 121 patients (90%), and motor abnormalities were observed in 76% of patients.
The location of CSDH was right-sided in 43% of cases, left-sided in 30%, and bilateral in 27%. Burrhole craniostomy was performed in all patients with the use of a closed drainage system. The complication rate was 7%, and recurrence and mortality rates were 4% each.
Conclusion: Altered consciousness was the most common clinical manifestation, and headache was the predominant symptom. Hypertension was the most frequently associated co-morbidity. Burrhole craniostomy with a closed drainage system was the preferred surgical approach, demonstrating high efficacy and a low complication rate.
