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Predictive (subtle or overlooked) initial head CT findings in patients who develop delayed chronic subdural hematoma
Institution:1. Department of Neurosurgery, Carle Foundation Hospital, University of Illinois College of Medicine at Urbana-Champaign, Urbana, IL 61801, USA;2. Department of Radiology, Carle Foundation Hospital, Urbana, IL 61801, USA;3. Department of Chemistry, University of Illinois at Urbana Champaign, Urbana, IL 61801, USA;1. Department of Neurological Surgery, University of California, Davis, Sacramento, CA 95811, United States;2. Department of Radiology, University of California, Davis, Sacramento, CA 95811, United States;1. InterMountain Neurosurgery and Neuroscience, St. Anthony Hospital, Lakewood, USA;2. Trauma Research Department, St. Anthony Hospital, Lakewood, USA;3. Trauma Services Department, St. Anthony Hospital, Lakewood, USA;4. College of Osteopathic Medicine, Rocky Vista University, Parker, Colorado, USA;1. School of Medicine, University of Missouri-Kansas City, Kansas City, Missouri, USA;2. Department of Neurosurgery, University of Kansas Medical Center, Kansas City, Kansas, USA
Abstract:With the aging population, the incidence of chronic subdural hematoma (CSDH) is expected to rise. Once symptomatic the morbidity from CSDH is not insignificant. We studied patients who had a minor head injury and CT brain scan prior to developing CSDH to determine if there were any predictors on these scans for subsequent development of a CSDH. A retrospective review was performed on all patients operated for CSDH over a 3-year period and a review performed on those who had imaging studies at the time of a preceding minor head injury. Seven of 37 patients had CT scans prior to developing CSDH. All had evidence of small increases in CSF intensity on the side or sides of the subsequent CSDH. In conclusion, in those patients with a history of minor head injury prior to developing a CSDH, CT brain demonstrated small increases in cerebral spinal fluid (CSF) intensity on the side or sides of the subsequent CSDH. Recognizing this finding may be helpful in monitoring these patients or initiating medical therapy.
Keywords:Chronic subdural hematoma  Subdural hygroma  Minor head injury  Cerebral spinal fluid intensity
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