Comparison of clinical characteristics in patients presenting with chronic bilateral subdural hemorrhage between over and under age 65

초록

Objective Chronic subdural hematoma (CSDH) is relatively frequent problem in elderly patients. Clinical characteristics of bilateral CSDH in old patients are unclear. The purpose of this study is to compare the clinical characteristics between patients with ≥65 and <65 years old. Methods A retrospective study was performed on 35 surgical patients with bilateral CSDH from April 2004 to October 2013. These patients were divided into two groups, age over 65 and under 65. Clinical presentations, precipitating factors, computed tomography (CT) scan findings, postoperative complications and outcomes were analyzed. Results The mean age was 68.3 for patients with bilateral CSDH. 24 patients were 65 years old and more. Older age group patients had more dependency compared to younger age group patients. Mental change was the most common symptom in older patients (p-value=0.023). Hypertension was significantly higher in older age group (p-value= 0.05). In older age group, more cerebral cortical atrophy was found in CT scans (p-value=0.02). Complications related surgery were extremely rare and surgery both side at the same time were equally safe to one side burr-hole surgery. Clinical outcome was good in both groups. Conclusion Bilateral chronic subdural hemorrhage was more frequently developed in old age patients and mental change was also more frequent in old age group. Although prognosis is relatively benign in elderly patients, re-operation influenced negative effects upon patients. Bilateral burr-hole surgery at one step was effective and safe. So both side surgery at one time should be considered even though the patients were old.

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