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J R Soc Med 2002;95:290-292
doi:10.1258/jrsm.95.6.290
© 2002 Royal Society of Medicine

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J R Soc Med 2002;95:290-292
© 2002 The Royal Society of Medicine

Chronic subdural haematoma in the elderly—a North Wales experience

Muhammad Asghar MRCP   Vedamurthy Adhiyaman MRCP  1 M W Greenway FRCP  1 Bhimal K Bhowmick FRCP  1   A Bates FRCP  2

Gloucestershire Royal Hospital, Gloucester GN1 3NN, UK
1 Department of Geriatric Medicine, Glan Clwyd District General Hospital, Rhyl, Denbighshire LL18 5UJ, UK
2 Ysbyty Gwynedd, Bangor, Gwynedd LL57 2PW, UK

Correspondence to: Dr V Adhiyaman E-mail: adhiv{at}btinternet.com

Chronic subdural haematoma (CSDH) is predominantly a disease of the elderly. Most of the existing data come from studies done several decades ago. We examined the incidence, risk factors, clinical presentation, management and outcome in elderly patients with CSDH by retrospective study of the period 1996-1999 in the three district hospitals of North Wales.

40 cases of CSDH were identified in patients >65 years, the incidence in this population being 8.2/100 000. Falls (57%) and antithrombotic therapy (33%) were the most frequent risk factors. The most common presenting features were altered mental state (52%) and focal neurological deficit (50%). 24 patients (60%) underwent surgical intervention with 4 deaths (17%). In the non-operated group mortality was 7/16 (44%).

Most of the deaths in this series were due either to CSDH or to the complications of frailty and poor mobility. Surgery itself was generally successful.


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