Korean J Neurotrauma.  2012 Oct;8(2):115-121. 10.13004/kjnt.2012.8.2.115.

A Clinical Analysis in Risk Factors of Chronic Subdural Hematoma: Focusing on the Age

• Sim YW
• Min KS
• Lee MS
• Kim YG
• Kim DH

• KMID: 1427724
• DOI: http://doi.org/10.13004/kjnt.2012.8.2.115

Abstract

OBJECTIVE
The current understanding reveals that chronic subdural hematoma (CSDH) is mostly the results of direct or indirect head trauma. Other factors such as alcoholism, medication (such as anticoagulants or antiplatelet agents), liver cirrhosis, chronic renal failure and hematologic disease are also well known as causes of CSDH. Of them, the authors attempted to identify the risk factors of CSDH by focusing on the age with a view point of recent increase in the elderly population.
METHODS
We retrospectively reviewed 216 consecutive CSDH patients who underwent surgery at our institute between 2002 and 2011. We classified them into two groups according to the patients' age (Group A: <65 years old, Group B: > or =65 years old). Various factors were investigated for risk factor of CSDH, such as head trauma, chronic alcoholism, epilepsy, previous shunt surgery, underlying disease having bleeding tendency or medication affecting blood coagulation. And these factors were compared between the two groups for statistical significance.
RESULTS
Among the 216 patients, group A included 81 patients (37.5%), group B included 135 patients (62.5%). The medication of group B had significantly more proportion than group A, comparing to the result that group B had relatively less proportion of head trauma and alcoholism (p<0.05). And medication was more associated with non-traumatic CSDH, especially in group B.
CONCLUSION
As previously reported, head trauma or alcoholism are also most important causes as a risk factor of CSDH of all ages in our study. But medication is more closely related to the incidence of CSDH in group A, than group B.

Keyword

Chronic subdural hematoma; Risk factor; Age; Platelet aggregation inhibitor; Anticoagulants

MeSH Terms

Aged
Alcoholism
Anticoagulants
Blood Coagulation
Craniocerebral Trauma
Epilepsy
Hematologic Diseases
Hematoma, Subdural, Chronic
Hemorrhage
Humans
Incidence
Kidney Failure, Chronic
Liver Cirrhosis
Retrospective Studies
Risk Factors
Anticoagulants

Figure

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  FIGURE 1. The risk factors of CSDH in 216 patients subdivided according to age and percentage of patients with each risk factor. CSDH: chronic subdural hematoma.

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  FIGURE 2. The percentage of medication as risk factor of CS-DH subdivided according to age and head trauma history. CSDH: chronic subdural hematoma.

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