Chronic subdural haematoma: a clinical survey

ABSTRACT

Seventy-four cases of proven chronic subdural haematoma seen at the University Hospital of the West Indies between 1962 and 1971, were reviewed. The main problem associated with this condition remains one of diagnosis. The increasing incidence with age, and the increasing age and incidence of trauma in the population add to the relevance of a study of this condition. The clinical features are diversed and, for the most part non-specific; thus, the basis for initiating the diagnosis is still an adequate history and a high index of suspicion. Any patient with a history of trauma, presenting with headache, weakness, fluctuating changes in conscious level, or any combination of these features, should be investigated to rule out chronic subdural haematoma. Of various special investigations, carotid angiography proved to be the most useful. Simple burr hole evacuation was adequate treatment in 88 percent of the patients, only a minority requiring a more major neurosurgical procedure. The ultimate prognosis of patients with this condition is good, provided diagnosis is made early and treatment is prompt and adequate (AU)