title: Increasing incidence of chronic subdural haematoma in the elderly.
abstract: BACKGROUND
  Chronic subdural haematoma (CSDH) is a condition predominantly affecting the elderly. We reported an incidence of 8.2 per 100 000 per year in people above the age of 65 in 2002.
  
  
  OBJECTIVE
  Since recent studies have demonstrated a higher incidence, we repeated our study to estimate the current incidence of CSDH amongst people above the age of 65 in North Wales.
  
  
  METHODS
  We used radiological reports to identify patients with CSDH over a 1-year period.
  
  
  METHODS
  We collected data on demographics, clinical presentations, indications for brain imaging, drug history and 30-day outcome from the case notes and electronic records.
  
  
  RESULTS
  The population of North Wales was 687 937 of which 138 325 (20%) were above 65. There were 66 cases of CSDH giving an incidence of 48 per 100 000 per year. Mean age was 81 and there were 32 males and 34 females. Falls and confusion were the commonest indications to request a CT scan (90%). Other indications were drowsiness (9%) and focal neurological deficit (4%). 17 were on antiplatelets and 20 were on warfarin. Ten underwent surgical intervention. At 30 days 28 were discharged, 22 were still in hospital and 16 died.
  
  
  CONCLUSIONS
  The incidence of CSDH is much higher than previously reported. Reasons include a low threshold for imaging patients with recurrent falls and confusion, increasing use of anti-thrombotics and ageing population. In many older patients CSDH is a marker of underlying co-morbidities rather than a primary event.
authors.affiliation: From the Glan Clwyd Hospital, Rhyl, LL18 5UJ, UK.
authors.forename: V
authors.initials: V
authors.lastname: Adhiyaman
authors.affiliation: From the Glan Clwyd Hospital, Rhyl, LL18 5UJ, UK.
authors.forename: I
authors.initials: I
authors.lastname: Chattopadhyay
authors.affiliation: From the Glan Clwyd Hospital, Rhyl, LL18 5UJ, UK.
authors.forename: F
authors.initials: F
authors.lastname: Irshad
authors.affiliation: Wrexham Maelor Hospital, Wrexham, UK.
authors.forename: D
authors.initials: D
authors.lastname: Curran
authors.affiliation: Wrexham Maelor Hospital, Wrexham, UK.
authors.forename: S
authors.initials: S
authors.lastname: Abraham
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D003221:Confusion / Q000453:epidemiology / Q000209:etiology; D005260:Female; D020200:Hematoma, Subdural, Chronic / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D014057:Tomography, X-Ray Computed; D014852:Wales / Q000453:epidemiology