title: Restoration of Functional Integrity After Evacuation of Chronic Subdural Hematoma-An Age-Adjusted Analysis of 697 Patients.
abstract: OBJECTIVE
  Although chronic subdural hematoma (CSH) can be treated by surgery, little is known about age-dependent symptoms and age-adjusted rates of restoring functional integrity. To evaluate the clinical symptoms and the course of CSH in patients of different age groups (AGs), we reviewed patients with CSH treated at our department over the past 22 years.
  
  
  METHODS
  This retrospective analysis included 697 patients with CSH (461 men, 236 women; mean age 70.1 years). Subgroup analysis was done according to AG 1) <65 years, 2) 66-75 years, 3) 76-85 years, 4) 86-95 years, and 5) >95 years.
  
  
  RESULTS
  Most patients had been treated with burr-hole trephination and implantation of a subdural drain (96.5%; n = 673). No significant difference concerning surgical morbidity and mortality was found between the AGs, but patients >75 years more frequently required reoperation (P = 0.001). Preoperatively, the most common symptoms were headache in AGs 1 and 2 (56.3% and 48.5%) and mnestic deficits in AGs 3-5 (54.9%, 51.9%, and 50.0%). After surgery, the clinical symptoms of CSH had significantly abated in all age groups. The most common clinical residuals were motor deficits in AG 1 (10.4%), mnestic deficits in AG 2 (10.7%), AG 4 (24.1%), and AG 5 (50.0%), and organic brain syndrome in AG 3 (15.0%).
  
  
  CONCLUSIONS
  CSH predominantly caused unspecific symptoms such as headache and cognitive decline. CSH surgery immediately relieved symptoms in patients of all AGs. However, improvement rates significantly depended on patient age. This should be taken into consideration when advising on surgical treatment of CSH.
authors.affiliation: Department of Neurosurgery, University Regensburg Medical Center, Regensburg, Germany. Electronic address: petra.schoedel@ukr.de.
authors.forename: Petra
authors.initials: P
authors.lastname: Schoedel
authors.affiliation: Department of Neurosurgery, University Regensburg Medical Center, Regensburg, Germany.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Bruendl
authors.affiliation: Department of Neurosurgery, University Regensburg Medical Center, Regensburg, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Hochreiter
authors.affiliation: Department of Neurosurgery, University Regensburg Medical Center, Regensburg, Germany.
authors.forename: Judith
authors.initials: J
authors.lastname: Scheitzach
authors.affiliation: Department of Neurosurgery, University Regensburg Medical Center, Regensburg, Germany.
authors.forename: Sylvia
authors.initials: S
authors.lastname: Bele
authors.affiliation: Department of Neurosurgery, University Regensburg Medical Center, Regensburg, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Brawanski
authors.affiliation: Department of Neurosurgery, University Regensburg Medical Center, Regensburg, Germany.
authors.forename: Karl-Michael
authors.initials: KM
authors.lastname: Schebesch
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D015984:Causality; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy / Q000401:mortality / Q000706:statistics & numerical data; D015897:Comorbidity; D056424:Decompressive Craniectomy / Q000401:mortality* / Q000706:statistics & numerical data; D004322:Drainage / Q000401:mortality* / Q000706:statistics & numerical data; D005260:Female; D005858:Germany / Q000453:epidemiology; D020200:Hematoma, Subdural, Chronic / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000175:diagnosis / Q000401:mortality* / Q000517:prevention & control*; D015995:Prevalence; D020127:Recovery of Function; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult
keywords: Age-adjusted analysis; Chronic subdural hematoma; Detailed symptom description; Symptom relief