A Retrospective Study On The Clinical Features Of Chronic Subdural Hematoma

Objective: Chronic Subdural Hematoma(CSDH) is a common neurologic disease among the elderly. The complex and mysterious mechanism and pathophysiology lead to the lantant and variable clinical features of this kind of disease. This study is done to have a further learning of the clinical manifestation of CSDH through the review of the cases in terms of general conditions, clinical features, therapy and the prognosis.At the same time, a comparison is done between traumatic CSDH group and non-traumatic CSDH group in order to get the difference points.Methods: 307 patients who were hospitalized and treated in the neurosurgery department of shanghai sixth people’s hospital from January of 2010 to December of 2014 were selected. Analysis is done on the general conditions, clinical features, therapy and the prognosis of CSDH. Then all the patients were devided into two groups according to whether the patient had head trauma before showing the symptoms of CSDH so as to make a contrastive analysis between the two groups on the general conditions.Results: Common features of CSDH: 1) There are 226 male patients and 81 female patients among the whole 307 patients with CSDH. The number of the male patients is much more than the female patients. 2) The average age of the whole patients is 68.66±13.52, the old is much more than the young and the occurrence of CSDH is getting higher from age 51, and the peak of the onset age arrangers from 71 to 80. 3)The initial symptom of CSDH includes: headace(48.21%), myasthenia(24.76%), unconsciousness(10.42%), dizziness(8.79%), inhibited walking(3.91%), aphasia(3.25%), uracratia(0.33%), mental symptom(0.33%). 4) 282 patients were treated by surgery(91.86%), and 186 of these patients were found pneumocephalus and encephalic fluid after operation. Differences between two groups: 1)The morbidity of diabetes mellitus in the non-traumatic group is differ from traumatic group(P<0.05). 2) The morbidity of coronary heart disease in non-traumatic group is different with the traumatic group(P<0.05).Conclusion:1)CSDH has a trend in the old man, and the peak of the onset age is from 71 to 80. 2) The hematoma is often seen in the left frontal, temporal, parietal area, and headache is the most common symptom of CSDH amount to half of the patients. The burr-hole craniostomy and irrigation with closed-system subdural drainage and irrigation is the primary treatment method. Intracranial pneumatosis and encephalic fluid is the main complication after operation. Majority of the patients can be cured after the treatment, while the minority died. 3) The morbidity of diabetes mellitus and coronary heart disease in non-traumatic group is higher than those in traumatic group, which may lead to the possibility theory that these two diseases may be the inducement of the hematoma formation in non-traumatic CSDH patients.