[A comparison of the results of treatment in young and elderly patients with chronic subdural hematoma depending on the method of surgery].
BACKGROUND
Chronic subdural hematoma (CSDH) generally occurs in patients past the age of 50 years but may develop at any age, also in young persons. The aim of this study was to compare the results of treatment in young and elderly patients with CSDH depending on the method of surgery: burr hole (group A) or craniotomy (group B).


METHODS
This retrospective study was based on medical histories and computed tomography findings in patients with CSDH operated at the Department of Neurotraumatology, Jagiellonian University, in 1983-2003. Altogether, 114 patients were analyzed including 35 (30.7%) patients under the age of 40 years and 79 (69.3%) patients over the age of 75 years.


RESULTS
A significant correlation between the result of treatment and age of patients with CSDH was demonstrated. The best result (Glasgow Outcome Scale = 5) was achieved in 73.9% of young patients in the trepanation group and in 66.7% in the craniotomy group as opposed to just 15.5% of elderly patients in the trepanation group and 4.8% in the craniotomy group. The difference between young and elderly patients was significant (p = 0.00001 for burr hole surgery, p = 0.0006 for craniotomy). Burr hole evacuation offered better results than craniotomy.


CONCLUSIONS
(1) The results of treatment were much better in young than in elderly patients. (2) Comparison of the results of treatment of chronic subdural hematoma shows that burr hole surgery is the preferable procedure.
Krupa
Mariusz
M
Klinika Neurochirurgii i Neurotraumatologii Collegium Medicum Uniwersytetu Jagielloliskiego ul. Botaniczna 3, 31-503 Kraków.
Stachura
Krzysztof
K
Moskala
Marek
M
D000328:Adult; D000368:Aged; D003399:Craniotomy / Q000379:methods*; D023261:Glasgow Outcome Scale; D020200:Hematoma, Subdural, Chronic / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D008487:Medical History Taking; D008875:Middle Aged; D012189:Retrospective Studies; D012737:Sex Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome