Chronic subdural hematoma in patients under age 65 years: A comparative study of age cohort

Background: Chronic subdural hematoma (CSDH) in patients 65 years old is not uncommon, but its exact situation is not well-clarified. Purposes: In this study, we compare the clinical variables between two age groups (<= 65 years and >65 years), and focus on the characteristics of younger adults. Methods: In this 2-year retrospective study, 98 patients with CSDH were enrolled and subdivided into younger (<= 65 years) and older (>65 years) groups. Information about presenting symptoms and neuroimages was recorded. We also investigated recurrence, morbidity, mortality, and neurological outcome after burr hole craniotomy. Results: The patients <= 65 years accounted for 29% of the CSDH cases. Younger adults had a lower incidence of hemiparesis than older patients (p = 0.03). Analysis of the computerized tomography (CT) scans on admission revealed differences in layering of the hematoma (p = 0.009) and multiplicity of hematoma cavities (p = 0.001). The recurrence rate was 18% for the younger group and 13% for the older group (p = 0.53). The occurrence of postoperative morbidity and mortality was similar in the two age groups (p > 0.99 and p = 0.56, respectively). An unfavorable Glasgow Outcome Scale was not observed in any of the younger patients, but was seen in six of the older patients; however, there was no statistically significant difference between the age groups (p = 0.18). Conclusion: The clinical presentations and CT features of patients <= 65 years of age varied from those of older patients. Clinicians should note this variability to facilitate proper management. Copyright (C) 2012, Taiwan Surgical Association. Published by Elsevier Taiwan LLC. All rights reserved.