Subacute and chronic subdural hematoma in young population less than 40 years

Objective: The objective of this study was to analyze clinical, radiological and surgical results of subacute and chronic subdural hematomas (CSDH) in young patients less than 40 years. Methods: This is a retrospective study of young patients who were surgically treated for subacute and chronic SDH during a 10-year period from 2002 to 2012. A total of 1642 patients were treated for these conditions, of which 136 patients (0.083%) were of 40 years or less. Complete clinical, surgical, and radiological records were available for 92 (15 female and 77 male) patients. Results: 79 (86%) cases had history of prior trauma. However few cases had association with toxoplasmosis, renal failure, hypothyroidism and VP shunt. Young patients mainly presented with symptoms of raised intracranial pressure and around 19% had history of alcohol abuse. 13 cases had altered blood parameters. Overall results of surgery were good. Post-operative recurrence was seen in only 13 cases. Conclusion: Young adults with CSDH show less severe clinical and radiologic features as well as fewer recurrences than noted in the elderly population. In young adults with unexplained headaches, there should be low threshold for computed tomographic scan of brain. Burr hole evacuation is satisfactory and histological examination is mandatory particularly in cases where there is no history of trauma. Copyright (C) 2014, Neurotrauma Society of India. All rights reserved.