A Clinical Analysis of Chronic Subdural Hematoma.

Park, Hyuck; Rhee, Dong Youl

Original Article

Journal of Korean Neurosurgical Society 1987;16(2): 377-388.

Department of Neurosurgery, Wallace Memorial Baptist Hospital, Pusan, Korea.

ABSTRACT

The authors presented 36 cases of chronic subdural hematoma which were diagnosed by operation from Fed. 1984 to Aug. 1986 at the Dept. of Neurosurgery, Wallace Memorial Baptist Hospital. The results were summarized as the followings : 1) Males were more frequently involved than female with the ratio of 3.5 : 1, common incidence of age was between 6th decade and 7th decade. 2) Most of the cases(88.9%) had a history of craniocerebral injury and some of them had an alcoholism(38.9%). 3) Older age(more than 50 years) group had more frequent mental changes(80%), and focal neurological deficit such as headache(62.5%) and vomiting(62.5%). 4) The hematoma density of CT scan showed isodense(38.9%), mixed dense(33.3%), hypodense(16.7%), or hyperdense(11.1%) lesion, that was not correlated with duration after head trauma. 5) The hematoma shale of CT scan showed biconvex shape(80%) in older age group that did not show the relation between hematoma shape and the duration of hematoma age. 6) Of the 36 cases, 24 cases were treated with burr hole drainage and intermittent valsalva maneuver, 12 cases with craniotomy and membranectomy, but the operative method did not affect the postoperative results. 7) The analysis and pathological review of hematoma blood and membrane showed the possible role of bleeding from outer membrane to hematoma expansion.

Key Words: Chronic subdural hematoma; Craniocerebral injury; Neurological deficit; Hematoma; Surgical treatment