[Clinical features and surgical results of chronic subdural hematoma in the extremely aged patients].
Since low-invasive surgery provides marked symptomatic improvement of patients with chronic subdural hematoma, surgery will be recommended also for the aged. To examine the clinical features and treatment result in the aged patients, we compared the clinical features and surgical results in two groups of patients with 80 or more and less than 80 years. The subjects consisted of 266 adult patients with a total of 333 chronic subdural hematomas who had undergone closed-system drainage between January 1995 and March 2005. The items analyzed were 1) patients background including gender, laterality of hematoma, presence or absence of history of head trauma, history of drinking, and mechanism of injury, 2) clinical symptoms, such as level of consciousness on initial examination, initial symptoms, and the degree of paralysis, 3) those related to surgery, such as time from injury to surgery, length of hospital stay, operation time, and amount of drainage, 4) outcome, such as presence or absence of symptomatic improvement, and recurrence rate. The results of this study showed that chronic subdural hematomas in the extremely aged patients were characterized by 1) infrequent history of head trauma, 2) infrequent headache and frequent dementia, incontinence and deterioration of activity at onset, 3) severe degree of motor paralysis at admission, 4) larger amount of drainage volume, 5) low incidence of outcome improvement. Above these characteristics should be considered at the decision making of surgical treatments for extremely aged patients with chronic subdural hematoma.
Ooba
Satomi
S
Department of Neurosurgery, Kurume University School of Medicine, 67 Asahicho, Kurume-city, Fukuoka 830-0011, Japan. ksatomi@med.kurume-u.ac.jp
Shiomi
Naoto
N
Shigemori
Minoru
M
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking; D006259:Craniocerebral Trauma / Q000150:complications; D004322:Drainage / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D020200:Hematoma, Subdural, Chronic / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome