title: [Postoperative course after acute traumatic subdural hematoma in the elderly. Does the extent of craniotomy influence outcome?].
abstract: OBJECTIVE
  The goal of the study was to analyze the short-term outcome after surgical treatment of acute subdural hematomas in two treatment groups in a patient population >65 years. Whether there are disadvantages from invasive treatment or whether advantages can be achieved with the less invasive treatment has not been previously examined in a prospective study.
  
  
  METHODS
  A prospective, nonrandomized study of 50 patients >65 years with acute traumatic subdural hematoma was performed, comparing the short-term outcome after two different primary surgical procedures: limited craniotomy (group A, n=25) and large decompressive craniectomy (group B, n=25).
  
  
  RESULTS
  There were no differences of hematoma volume, degree of midline structure shift, and time from trauma to operation between the two groups. Initial Glasgow coma scale and short-term outcome after 4 weeks measured by the Glasgow outcome score in both groups showed no significant differences.
  
  
  CONCLUSIONS
  No significant differences between short-term outcome after limited craniotomy versus large decompressive craniectomy were found for patients >65 years, and the results indicate that decompressive craniectomy can be accepted as a surgical treatment option for acute traumatic subdural hematoma even in elderly patients.
authors.affiliation: Neurochirurgische Klinik, Bundeswehrkrankenhaus Ulm, Oberer Eselsberg 40, Ulm, Germany. chr74@gmx.de
authors.forename: C
authors.initials: C
authors.lastname: Schulz
authors.forename: U M
authors.initials: UM
authors.lastname: Mauer
mesh_terms: D000368:Aged; D003399:Craniotomy / Q000379:methods*; D005260:Female; D046648:Hematoma, Subdural, Intracranial / Q000175:diagnosis* / Q000601:surgery*; D006801:Humans; D008297:Male; D011184:Postoperative Period; D016896:Treatment Outcome