Updates in Chronic Subdural Hematoma: Epidemiology, Etiology, Pathogenesis, Treatment, and Outcome

James Feghali, Wuyang Yang, Judy Huang

Research output: Contribution to journalReview article

Abstract

Chronic subdural hematoma (CSDH) is a complex disease with an overall incidence of 1.7–20.6 per 100,000 persons per year and is more commonly encountered in the elderly population. The pathophysiologic cycle of CSDH formation and expansion involves traumatic and inflammatory components that promote the formation of membranes with permeable neovessels. Many drugs targeting different elements of this cycle are being actively investigated as potential therapeutic agents in CSDH. Burr hole craniostomy appears to be the most commonly used procedure for surgical evacuation, and outcomes are generally favorable. Recurrence can occur in 10%–20% of patients and is associated with several clinical and radiographic predictors. Middle meningeal artery embolization represents one of the latest additions to the therapeutic arsenal of cerebrovascular specialists in treating CSDH and is being critically evaluated in numerous ongoing clinical trials.

Original languageEnglish (US)
Pages (from-to)339-345
Number of pages7
JournalWorld neurosurgery
Volume141
DOIs
StatePublished - Sep 2020

Keywords

  • Chronic subdural hematoma
  • Epidemiology
  • Etiology
  • Outcome
  • Pathogenesis
  • Treatment

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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