[Chronic subdural hematoma - assessment and management].
Subdural hematomas (SDH) are associated with an increased morbidity and mortality and generally occur as chronic SDH among older patients. The most frequent signs and symptoms - like headache, alteration of consciousness, gait impairment and hemiparesis - are also prevalent among other diseases, which has to be taken into account in the differential diagnosis. In the case of symptomatic patients with focal neurological deficits, a surgical intervention should be considered, whereas in case of asymptomatic patients or patients with only slight headaches, also a conservative treatment with a clinical and radiological follow-up might be a possibility. Also after surgical intervention, the recurrence rate is between 5 and 33%. Therefore, all patients with chronic SDH depict, irrespective of the indication for an oral anticoagulation, a challenge for the treating physicians.
Klinik für Neurochirurgie, Kantonsspital St. Gallen, St. Gallen. Oliver.Gautschi@kssg.ch
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Gautschi
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Gallay
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Kress
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Korte
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Hildebrandt
D000368:Aged; D000465:Algorithms; D000925:Anticoagulants / Q000009:adverse effects; D003937:Diagnosis, Differential; D005260:Female; D016489:Head Injuries, Closed / Q000150:complications; D006408:Hematoma, Subdural / Q000175:diagnosis / Q000628:therapy; D020200:Hematoma, Subdural, Chronic / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects; D011379:Prognosis; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D014207:Trephining
D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors