CHRONIC SUBDURAL HEMATOMA

Abstract

Cases of chronic subdural hematoma were studied retrospectively to clarify difficulties of clinical diagnosis. The combination of headache due to raised intracranial pressure, fluctuating drowsiness and mild hemiparesis may suggest subdural hematoma but is not always present and epilepsy, aphasia, hemianopia and dense hemiplegia can all occur contrary to textbook descriptions. Head injury or other etiological factors are usually absent. Presentation may mimic tumor, dementia, cerebrovascular accident or subarachnoid hemorrhage. Non invasive investigations may yield false negative results, although radionuclide scanning and computerized axial tomography have a reliability of .apprx. 90%. Diagnosis by angiography is not predicted in a percentage of cases.