Clinical Analysis of Chronic Subdural Hematoma

Moon, H B; Joo, H G; Jo, H W; Choi, W G; Yoon, S M

Abstract

The authors analysed 59 cases of chronic subdural hematomas which were treated surgically at the Department of Neurosurgery, Ulsan Dong Gang Hospital from January 1989 to August 1993. All hematomas were operated on by burr hole trephination and continuous closed-system catheter drainage as a safe, less invasive, and efficacious method. Male was predominant to female with the ratio 3.9 : 1 and the peak incidence was 50-60 years ago. Most of the cases had a history of head injury(75%). The patients were graded according to the scale proposed by Markwalder et al and 87% were in Grade 1 and 2. The major clinical systems and signs were headache(80%), consciousness deterioration(57%), motor weakness(48%), papilledema(25%). The hematoma densities shown on Brain CT scan were iso, hypo, and hyperdense in order of frequency. Among the patients a history of chronic alcoholism were presented in 38%, but we failed to identify any significant differences in clinical analysis between alcoholism group and non-alcoholism group. We have found that the preoperative neurological state was the most reliable prognostic factor.