Comparison of Clinical Characteristics in Patients Presenting with Chronic
Bilateral Subdural Hemorrhage Between Over and Under Age 65

, Kyung-Ho Cha; , Dong-Hyuk Park; , Kyung-Jae Park, Shin-Hyuk Kang; , Tai-Hyoung Cho; , Yong-Gu Chung

Clinical Article

Journal of Korean Society of Geriatric Neurosurgery 2014;10(2):144-151.
Published online December 30, 2014.

Comparison of Clinical Characteristics in Patients Presenting with Chronic Bilateral Subdural Hemorrhage Between Over and Under Age 65

Kyung-Ho Cha , Dong-Hyuk Park , Kyung-Jae Park, Shin-Hyuk Kang , Tai-Hyoung Cho , Yong-Gu Chung

Department of Neurosurgery, Anam Hospital, Korea University College of Medicine, Seoul, Korea

노인 환자에서 양측성 만성 경막하혈종 환자의 특성에 관한 임상 비교에 관한 고찰

차경호·박동혁·박경재·강신혁·조태형·정용구

고려대학교 의과대학 안암병원 신경외과학교실

Abstract

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.

Key Words: BilateralㆍChronic subdural hemorrhageㆍOld ageㆍClinical analysisㆍBurr-hole drainageㆍComplication