Introduction: The etiology of chronic subdural hematoma(CSDH) formation is debatable but many theories predispose bleeding into the subdural space that then for unclear reasons liquifies and enlarges over time. We retrospectively reviewed 300 consecutive patients admitted to a level 1 trauma center(within 24 hours of their injury) with an acute SDH or mixed density SDH on initial CT scan to determine the incidence of developing CSDH in this population
Methods: A retrospective review was performed using an electronic medical record with access to all inpatient records,imaging, and followup information. 300 consecutive patients admitted with acute or mixed SDH's demonstrated on CT of the head beginning in January 2007 thru early 2010 were reviewed. All patients had a history of head trauma within 24 hours of admission.
Results: The mean age was 54 years with a median of 60 years. 201 were males. 83 patients either died or had emergency surgery for large SDH. 202 patients were available for long term folloup. 4 patients developed enlarging CSDH that required surgical intervention. All had mixed SDH's at presentation. One had a vp shunt. None of the pure ASDH's became CSDH's requiring treatment.
Conclusions: The incidence of CSDH formation in patients presenting with ASDH's is very low. In our series the only patients who developed enlarging CSDH's requiring surgery were in those patients whose initial CT scan demonstrated a mixed density SDH.
Patient Care: Possibly decrease the need for CT scans
Learning Objectives: Learn about the formation of chronic SDH's