Cognitive Impairment in the Elderly with Chronic Subdural Hematoma

Objective: In the elderly, chronic subdural hematoma (CSDH) has impairment of cognitive function such as memory and language. But these rather nonspecific symptoms may lead to misdiagnosis such as dementia and false treatment. The aim of this retrospective study was the identification of the leading clinical symptoms in patient with the diagnosis CSDH who had been treated surgically. Methods: 79 patients with symptomatic CSDH (47 male, 32 female; mean age 69.0±10.4) who were admitted to our neurosurgical department from 2005 to 2007, were included in the study. We reviewed the medical records including clinical status, radiologic finding, history of trauma and postoperative recurrence of subdural hematoma. The instrument used for assessing cognitive functions was the Korean Mini-Mental State Examination (K-MMSE). Results: The preoperative symptoms were cognitive impairments in 43 patients (54.4%), followed by headache in 34 patients (43.0%), hemiparesis in 31 patients (39.2%) and dysarthria in 15 patients (20.3%). Simple burr hole trephination and hematoma evacuation were done in all patients. We found that all preoperative symptoms were improved. Conclusion: CSDH is an important differential diagnosis for dementia and neurodegenerative diseases, and an important reversible cause of dementia in elderly. If dementia is suspected, we should check early neuroimaging evaluation that may allow for timely treatment of this condition to avoid a poor outcome. (J Kor Neurotraumatol Soc 2008;4:66-69)