[Chronic subdural hematoma in patients over 80 years of age].
BACKGROUND
Chronic subdural hematoma (CSH) represents one of the most frequent types of intracranial hemorrhage. Most occur in elderly patients causing a variety of therapeutic problems associated to systemic diseases.


METHODS
A retrospective study of 90 patients older than 80 years of age with chronic subdural hematoma treated in the last 15 years was undertaken. For clinical evaluation on admission and at discharge we used the classification of Markwalder. Surgical treatment was performed in all patients and a burr hole craniostomy with closed drainage system was used.


RESULTS
On admission, 73 patients (80%) were in satisfactory condition (grades 0-2); 17 (20%) were grade 3 or 4. Seven (7.7%) patients died but none due to surgery. In 6 (6.6%) of the patients, surgical reintervention was required to remove a recurring CSH. In 76.6% of the patients, the results achieved were graded 0 or 1.


CONCLUSIONS
In our experience CSH in elderly patients should be treated with minimal surgery with a simple drainage of the subdural space. The good results suggest that the procedure could be considered as a first procedure in these patients and that age or concomitant diseases do not appear to be poor prognostic factors.
Gelabert-González
M
M
Servicio de Neurocirugía, Hospital Clínico de Santiago, Departamento de Cirugía, Universidad de Santiago de Compostela.
Fernández-Villa
J M
JM
López-García
E
E
García-Allut
A
A
D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D004322:Drainage / Q000379:methods; D005260:Female; D006408:Hematoma, Subdural / Q000601:surgery*; D006801:Humans; D008297:Male; D012189:Retrospective Studies