Download PDF
Indian Journal of Neurotrauma 2014; 11(01): 1-4
DOI: 10.1016/j.ijnt.2014.05.001
Original Article
Thieme Medical and Scientific Publishers Private Ltd.

Subacute and chronic subdural hematoma in young population less than 40 years

Pragyan Sarma
a   Senior Resident, Department of Neurosurgery, NIMHANS, Bangalore, Karnataka, India
,
B. Indira Devi
b   Professor and Head, Department of Neurosurgery, NIMHANS, Bangalore, Karnataka, India
,
Dhaval P. Shukla
c   Additional Professor, Department of Neurosurgery, NIMHANS, Bangalore, Karnataka, India
,
Dhananjaya I. Bhat
c   Additional Professor, Department of Neurosurgery, NIMHANS, Bangalore, Karnataka, India
› Author Affiliations
Subject Editor:
Further Information

Publication History

17 February 2014

01 May 2014

Publication Date:
06 April 2017 (online)

  PDF Download  Permissions and Reprints

Abstract

Objective

The objective of this study was to analyze clinical, radiological and surgical results of subacute and chronic subdural hematomas (CSDH) in young patients less than 40 years.

Methods

This is a retrospective study of young patients who were surgically treated for subacute and chronic SDH during a 10-year period from 2002 to 2012. A total of 1642 patients were treated for these conditions, of which 136 patients (0.083%) were of 40 years or less. Complete clinical, surgical, and radiological records were available for 92 (15 female and 77 male) patients.

Results

79 (86%) cases had history of prior trauma. However few cases had association with toxoplasmosis, renal failure, hypothyroidism and VP shunt. Young patients mainly presented with symptoms of raised intracranial pressure and around 19% had history of alcohol abuse.13 cases had altered blood parameters. Overall results of surgery were good. Post-operative recurrence was seen in only 13 cases.

Conclusion

Young adults with CSDH show less severe clinical and radiologic features as well as fewer recurrences than noted in the elderly population. In young adults with unexplained headaches, there should be low threshold for computed tomographic scan of brain. Burr hole evacuation is satisfactory and histological examination is mandatory particularly in cases where there is no history of trauma.

Keywords

Chronic subdural hematoma - Young adult - Recurrence
 

  • References

  • 1 Deok Won Yu, Hyeong-Joong Y., Le Young Jun, Chun Hyoung-Joon, Cho Hyun, Bak Koang-Hum. Chronic subdural hematoma in young adult: an age comparison study. Korean J Neurotrauma 2013; 09: 6-11
    CrossrefPubMedGoogle Scholar
  • 2 Robinson R.G.. Chronic subdural hematoma: surgical management in 133 patients. J Neurosurg 1984; 61: 263-268
    CrossrefPubMedGoogle Scholar
  • 3 Sambasivan M.. An overview of chronic subdural hematoma: experience with 2300 cases. SurgNeurol 1997; 47: 418-422
    PubMedGoogle Scholar
  • 4 Aoki N.. Subdural tapping and irrigation for the treatment of chronic subdural hematoma in adults. Neurosurgery 1984; 14: 545-548
    CrossrefPubMedGoogle Scholar
  • 5 Camel M., Grubb Jr. R.L.. Treatment of chronic subdural hematoma by twist-drill craniotomy with continuous catheter drainage. J Neurosurg 1986; 65: 183-187
    CrossrefPubMedGoogle Scholar
  • 6 Fogelholm R., Heiskanen O., Waltimo O.. Chronic subdural hematoma in adults. Influence of patient's age on symptoms, signs, and thickness of hematoma. J Neurosurg 1975; 42: 43-46
    CrossrefPubMedGoogle Scholar
  • 7 Grisoli F., Graziani N., Peragut J.C.. et al Perioperative lumbar injection of ringer's lactate solution in chronic subdural hematomas: a series of 100cases. Neurosurgery 1988; 23: 616-621
    CrossrefPubMedGoogle Scholar
  • 8 Kotwica Z., Brzezinski J.. Chronic subdural haematoma treated by burr holes and closed system drainage: personal experience in131. Br J Neurosurg 1991; 05: 461-465
    CrossrefPubMedGoogle Scholar
  • 9 Richter H.P., Klein H.J., Schäfer M.. Chronic subdural haematomas treated by enlarged burr-hole craniotomy and closed system drainage. Retrospective study of 120 patients. Acta Neurochir 1984; 71: 179-188
    CrossrefPubMedGoogle Scholar
  • 10 Ernestus R.I., Beldzinski P., Lanfermann H., Klug N.. Chronic subdural hematoma: surgical treatment and outcome in 104 patients. Surg Neurol 1997; 48: 220-225
    CrossrefPubMedGoogle Scholar
  • 11 Liliang P.C., Tsai Y.D., Liang C.L., Lee T.C., Chen H.J.. Chronic subdural haematoma in young and extremely aged adults: a comparative study of two age groups. Injury 2002; 33: 345-348
    CrossrefPubMedGoogle Scholar
  • 12 Fogelholm R., Heiskanen O., Waltimo O.. Chronic subdural hematoma in adults. Influence of patient's age on symptoms, signs, and thickness of hematoma. J Neurosurg 1975; 42: 43-46
    CrossrefPubMedGoogle Scholar
  • 13 Spallone A., Giuffrè R., Gagliardi F.M., Vagnozzi R.. Chronic subdural hematoma in extremely aged patients. Eur Neurol 1989; 29: 18-22
    CrossrefPubMedGoogle Scholar
  • 14 Hosoda K., Tamaki N., Masumura M., Matsumoto S., Maeda F.. Magnetic resonance images of chronic subdural hematomas. JNeurosurg 1987; 67: 677-683
    CrossrefPubMedGoogle Scholar
  • 15 Moon K.L., Brant-Zawadzki M., Pitts L.H., Mills C.M.. Nuclear magnetic resonance imaging of CT-isodense subdural hematomas. Am J Neuroradiol 1984; 05: 319-322
    PubMedGoogle Scholar
  • 16 Saleh J., Afshar F.. Diagnosis of chronic subdural haematoma: the advantages of MR imaging compared with the CT-scan. Br J Neurosurg 1987; 01: 369-374
    CrossrefPubMedGoogle Scholar
  • 17 Sipponen J.T., Sepponen R.E., Sivula A.. Chronic subdural hematoma: demonstration by magnetic resonance. Radiology 1984; 150: 79-85
    CrossrefPubMedGoogle Scholar