A Retrospective Analysis On Clinical Characteristics Of Patients With Chronic Subdural Hematoma

Objective:1.To analyze and summarize the clinical features of patients with Chronic Subdural Hematoma.2.To investigate the differences of clinical characteristics between unilateral and bilateral CSDH patients.Methods:1.All data of patients with CSDH admitted to neurosurgery department of chengdu second people's hospital since 2015.01 to 2019.12 were collected,including general situation,clinical complications,personal history,clinical manifestations and clinical diagnosis and treatment.Then,analysis is done with SPSS 20.0 software.2.All patients were divided into two groups according to unilateral CSDH and bilateral CSDH,so as to make a X~2 test on their clinical features.Results:1.Clinical features of chronic subdural hematoma:(1)A total of 300 CSDH patients with complete case data were admitted in this study,including 250 males(83.3%)and 50 females(16.7%).Since the age of 61,the number of patients has increased significantly.The average age of onset was 74.26±12.24 years old,and the peak age of onset was 81-90 years old.The average length of hospitalization of patients was 14.12 days.(2)The proportion of CSDH patients with combined trauma history(73.3%),hypertension,diabetes and heart disease(46.6%,22%and 13.3%).(3)The most common clinical symptoms of CSDH patients were limb weakness(43.3%),followed by dizziness and headache(34.7%),decreased consciousness(14.7%),verbal confusion(5.3%),and psychiatric symptoms(2.0%).At the time of admission,212 patients(70.7%)were in grade I MGS,grade II,III,IV are58(19.3%),18(6.0%),12(4.0%).(4)Drilling drainage,272 cases(90.7%)as the preferred treatment,medicine conservative treatment of 28 cases(9.3%),after treatment,patients recovered from 282 cases(94.0%),18 cases of patients died(6.0%),discharge when the MGS class 0 114 cases(38.0%),grade I,164 cases(54.7%),grade II,III,IV are 4(1.3%),8(2.7%),10 cases(3.3%).III,IV,seriously ill patients died,the cause of death for preserving lung organ complications such as death,There were no fatal cases of surgical trauma.2.Differences in clinical characteristics between bilateral group and unilateral group:(1)In terms of clinical complications,the prevalence of diabetes in the bilateral group and the unilateral group was different,and the prevalence in the bilateral group was about twice as high as that in the unilateral group(P<0.05).(2)The prevalence of coronary heart disease in the bilateral CSDH group was much higher than that in the unilateral group(P<0.05).(3)There was a statistical difference between the two groups in taking anticoagulant and antiplatelet drugs(P<0.05),and the probability of taking anticoagulant and antiplatelet drugs in the bilateral CSDH group was much higher than that in the unilateral group.(4)In the unilateral group,152 patients(78.4%)received MGS grade I,28(14.4%)received MGS grade II,8(4.1%)received MGS grade III,6(3.1%)received MGS grade IV;In the bilateral group,60(56.7%)received MGS grade I,30(28.3%)received MGS grade II,10(9.4%)received MGS grade III,and 6(5.7%)received MGS grade IV.There were differences in MGS grading at admission,and the grading was more severe in the bilateral group(P<0.05).(5)Postoperative hematoma recurrence was found in 10patients with bilateral CSDH(9.4%)and there were 4 cases(2.1%)in the unilateral group;The postoperative recurrence rate in the bilateral group was higher than that in the unilateral group(P<0.05).Conclusion:1.Chronic subdural hematoma usually occurs in elderly men,most of whom have a history of trauma,and the mean hospitalization time is 14.12 days.2.The drilling and drainage is the first choice for the treatment of CSDH;The number of patients who choose drug treatment is low.3.The first symptom of chronic subdural hematoma was limb weakness,and most of the patients received grade I MGS on admission.The bilateral group had higher MGS and more severe clinical symptoms at admission.4.Diabetes and coronary heart disease may be the basic diseases inducing bilateral CSDH in patients.5.Anticoagulant and antiplatelet drugs are closely related to bilateral CSDH hemorrhage.6.The recurrence rate of postoperative hematoma in bilateral CSDH group was higher than that in unilateral group.