Clinical Presentation Variants of Chronic Subdural Hematoma Cases
DOI:
https://doi.org/10.65693/j21umas.2025.v4i1.217Keywords:
Clinical Presentation, Chronic Subdural Hematoma, Yemen.Abstract
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Background: Chronic subdural hematoma (CSDH) is a prevalent condition in neurosurgical practice, predominantly affecting the elderly. However, there is a paucity of data concerning the characteristics of CSDH patients within Middle Eastern populations including Yemen.
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Aim of study: This study aims to systematically evaluate the clinical presentations of patients diagnosed with chronic subdural hematoma.
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Methodology: A retrospective descriptive study was obtained from registry medical records of patients with CSDH in Al-Thawra Modern General Hospital (TMGH) over a period of six years from January, 2017 to November, 2022. The collected data encompassed demographic and clinical characteristics including clinical presentation, Glasgow Coma Scale (GCS) at admission, etiology, laterality of the hematoma, management approaches and patient outcomes.
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Results: A total of 113 CSDH cases were analyzed, with 77.9% of the patients being male. The mean age was 61.8 years. Motor symptoms were the most common presenting feature, observed in 79.6% of cases, followed by symptoms of increased intracranial pressure (54.0%) and altered consciousness (46.0%). At admission, the majority of patients (54%) had a normal GCS score of 15, while 30.1% had GCS scores between 13 and 14. Left-sided hematomas were identified in 44.2% of patients, whereas 22.1% had bilateral presentations. The etiology remained unidentified in 45.1% of cases, with 30.1% having a history of a ground-level fall and 16.8% having a history of traffic accidents. Surgical intervention via burr hole was performed in 92.9% of patients, with a favorable outcome observed in the majority. The mortality rate was 3.5%.
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Conclusion: Chronic subdural hematoma exhibits a wide spectrum of clinical manifestations, with motor symptoms being the most prevalent. The condition predominantly affects elderly males. Most patients were successfully managed through burr hole surgery, with favorable outcomes in the majority. This single-institution, retrospective study presents findings consistent with global data. However, larger, multi-center studies are necessary to better elucidate the epidemiological profile and variable clinical presentations of CSDH.
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