• World Neurosurg · Dec 2019

    Comparative Study

    Comparison of clinical and radiological characteristics and prognosis of chronic subdural hematoma patients with and without a history of head trauma.

    • Jun Shen, Xuefei Shao, Qifu Wang, Ruixiang Ge, and Jianning Zhang.
    • Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China; Department of Neurosurgery, Yijishan Hospital of Wannan Medical College, WuHu, China.
    • World Neurosurg. 2019 Dec 1; 132: e391-e398.

    ObjectiveTo compare clinical and radiologic characteristics and prognosis of patients with chronic subdural hematoma (CSDH) with and without a history of head trauma.MethodsClinical and radiologic characteristics and prognosis of patients with CSDH with a history of head trauma (HT group) and without a history of head trauma (WHT group) were comparatively analyzed.ResultsMean age in the WHT group was 70.23 ± 11.53 years, which was significantly older than mean age 67.56 ± 11.18 years in the HT group (P = 0.008). Stroke, uremia, anticoagulant therapy, and antiplatelet therapy were encountered more often in the WHT group than the HT group. Motor weakness was more prevalent in the WHT group (P = 0.011). Modified Rankin Scale score of 2-3 was more common in the WHT group (P = 0.03), whereas a score of 4-5 was more common in the HT group (P = 0.014). Hematoma density on CT was mainly homogeneous in the 2 groups, with significantly more homogeneous density in the HT group compared with the WHT group (P = 0.014). There was significantly more mixed density in the WHT group (P = 0.001). Patients with CSDH in the WHT group had higher mortality (P = 0.026) and lower Glasgow Outcome Scale score (P = 0.033).ConclusionsPatients with CSDH with or without a history of head trauma presented with different clinical and radiologic characteristics. Patients with CSDH without a history of head trauma had a higher mortality and lower GOS score, which indicates these patients warrant more attention.Copyright © 2019 Elsevier Inc. All rights reserved.

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