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Chronic Subdural Hematoma 

Chronic Subdural Hematoma
Chapter:
Chronic Subdural Hematoma
Author(s):

Nathaniel Toop

, Benjamin McGahan

, Varun Shah

, and John McGregor

DOI:
10.1093/med/9780190936259.003.0004
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date: 02 July 2022

Chronic subdural hematomas are collections of blood in the subdural space. They can present variably in size and age. They can present as a single hemorrhage event or with evidence of repeated hemorrhages. They tend to be more common in an aging population. The associated trauma can be surprisingly minimal. The brain atrophy associated with old age allows for more room for subdural blood to pool prior to causing significant neurological dysfunction. They may occur spontaneously, and the symptoms relate to mass effect and irritation of the cortical surface. Treatment varies depending on presenting symptoms, size, chronicity, and degree of septations. Care should be taken in surgical cases to avoid disruption of the cortical surface, assure hemostasis prior to closure, and consider placement of a subdural drain. Growing evidence suggests there is a roll for conservative management in select presentations.

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