Chronic subdural hematoma in adult and elderly patients

Before the availability of CT, the ability of CSH to simulate the presentation of a wide variety of neurologic disorders led to the misdiagnosis of this condition in up to two thirds of these cases. Fortunately, the increased use of imaging for cerebrovascular disease, tumors, and dementia has led to increased detection of these lesions. Earlier diagnosis with a lower incidence of coma and decreased level of consciousness at presentation has been the end result, likely accounting for the decreased morbidity and mortality associated with this disease over the last 30 years. Nevertheless, the increasingly advanced age of patients with CSH and the varied clinical presentation in this age group can lead to potential delays in diagnosis in the elderly. In this expanding population of elderly patients with increased risks for medical and surgical complications, appreciation for the wide variety of clinical presentations and early diagnostic imaging are the keys to maintaining the low morbidity associated with this disease.