title: Chronic subdural hematoma: epidemiological and prognostic analysis of 176 cases.
abstract: OBJECTIVE
  To characterize patients with chronic subdural hematoma undergoing surgery and to identify prognostic indicators.
  
  
  METHODS
  We conducted a retrospective analysis of patients diagnosed with chronic subdural hematoma (CSDH) undergoing surgical treatment. We analyzed: age, period from trauma to diagnostic imaging, pre and postoperative Glasgow coma scale, type of surgery, associated comorbidities, use of postoperative drainage and outpatient treatment.
  
  
  RESULTS
  The sample consisted of 176 patients, 126 male and 50 female patients (ratio 2.5 : 1), ages ranged from six months to 97 years, with an average of 59.3 years. CSDH was caused by trauma in 52% of patients, with the time from trauma to imaging averaging 25.05 days; 37.7% were hypertensive patients and 20% had a neurological disease. Eighty-five (48.3%) patients were elderly and altered consciousness was present in 63% of cases. Of the 91 (51.7%) non-elderly patients, 44% presented with headache, altered consciousness occurred in 40% and motor abnormalities in 27.5%. The CSDH was located on the right in 41%, left in 43% and bilaterally in 16% of patients.
  
  
  CONCLUSIONS
  the change of consciousness was the most common clinical alteration in the elderly and headache in non-elderly. The most associated comorbidity was the arterial hypertension and the most frequent cause, head trauma. The trepanation with two oriffices associated with a closed drainage system was the most used operating, with high efficacy and low complication rate.
authors.affiliation: Faculdade de Ciências Médicas, Santa Casa de São Paulo, São Paulo, SP, Brasil.
authors.forename: Jamil
authors.initials: J
authors.lastname: Farhat Neto
authors.affiliation: Faculdade de Ciências Médicas, Santa Casa de São Paulo, São Paulo, SP, Brasil.
authors.forename: João Luiz Vitorino
authors.initials: JL
authors.lastname: Araujo
authors.affiliation: Faculdade de Ciências Médicas, Santa Casa de São Paulo, São Paulo, SP, Brasil.
authors.forename: Vinícius Ricieri
authors.initials: VR
authors.lastname: Ferraz
authors.affiliation: Faculdade de Ciências Médicas, Santa Casa de São Paulo, São Paulo, SP, Brasil.
authors.forename: Luciano
authors.initials: L
authors.lastname: Haddad
authors.affiliation: Faculdade de Ciências Médicas, Santa Casa de São Paulo, São Paulo, SP, Brasil.
authors.forename: José Carlos Esteves
authors.initials: JC
authors.lastname: Veiga
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003243:Consciousness; D004322:Drainage; D005260:Female; D020200:Hematoma, Subdural, Chronic / Q000453:epidemiology* / Q000628:therapy; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D055815:Young Adult