Clinical characteristics of chronic subdural hematoma in the patients associated with hematological diseases

Nakamura Homare, Kawaguchi Kimiyuki, Uchida Masashi, Onodera Hidetaka, Sakakibara Yohtaro, Taguchi Yoshio

doi:10.32187/neurotraumatology.39.2_89

Background and purposes: We retrospectively reviewed clinical features of chronic subdural hematomas in the patients with hematological diseases.Methods: A total of 410 patients with chronic subdural hematoma(s) admitted to St. Marianna University Yokohama City Seibu Hospital between 2008 and 2015 were reviewed. Among these patients, 9 corresponding cases were collected.Results: The average age of the patients was 65.5 years. In three out of 9 patients, preceding head injury was found in the past history. Based on complete blood counts on admission, blood transfusion was needed prior to surgical treatment in order to correct bleeding tendency mostly due to platelets deficiency. Because of cerebral herniation signs, emergency surgery was necessary in three patients. All underwent common burr hole aspiration surgery under local anesthesia. No surgical complication including postoperative hemorrhages was encountered. Neurological deficits were disappeared immediately after the surgery. However, another surgical treatment was added in 4 patients because of recurrent accumulation of subdural bloody fluid. Although nearly a half of the patients showed good prognosis, coexisting hematological disorders progressed to death within six months after the surgery in four out of 9 patients.Conclusion: Chronic subdural hematomas are generally recognized as a benign disease having good outcome when appropriate treatments were given. However, as the patients concomitantly having hematological diseases, their prognosis might be pessimistic.

Clinical characteristics of chronic subdural hematoma in the patients associated with hematological diseases

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