Cognitive Outcomes in Chronic Subdural Hematoma Patients Post-Treatment
Overview
This study prospectively assessed cognitive status in 56 chronic subdural hematoma (CSDH) patients three months after treatment, comparing them to a healthy elderly control group. Results highlight a high prevalence of cognitive impairment at presentation and provide insights into cognitive recovery following different treatment modalities.
Background
Chronic subdural hematoma (CSDH) is a common neurological condition, especially in the elderly, with incidence rising sharply with age. Patients often present with symptoms including headache, hemiparesis, gait disturbances, and cognitive complaints, the latter being particularly frequent in older patients. Cognitive impairment in CSDH has been described as potentially reversible after treatment, but prior studies have mostly assessed cognition shortly after intervention, leaving long-term cognitive outcomes unclear. Understanding cognitive status post-treatment is important for improving patient independence and quality of life.
Data Highlights
Characteristic
CSDH Patients (n=56)
Healthy Controls (n=60)
Mean Age (years)
72.1 ± 10.8
67.5 ± 4.8
Male Sex (%)
77%
43%
MGS Score 1 (%)
73%
Not applicable
Hematoma Laterality
Left 43%, Right 38%, Bilateral 21%
Not applicable
Treatment
Surgery 89% (64% surgery only, 36% surgery + dexamethasone)
Not applicable
Median Time to Cognitive Assessment (days)
93 (range 76–139)
Not applicable
Key Findings
45% of CSDH patients present with impaired cognitive status regardless of age.
Cognitive complaints at baseline include memory deficits, bradyphrenia, disorientation, and altered behavior.
Majority of patients (89%) received surgical treatment; some also received dexamethasone.
Cognitive status was assessed approximately three months post-treatment using the TICS-m.
Healthy controls were younger and had a higher proportion of females compared to CSDH patients.
Inclusion criteria excluded patients with severe neurological impairments or conditions affecting cognition to isolate CSDH effects.
Clinical Implications
Clinicians should be aware of the high prevalence of cognitive impairment in CSDH patients at presentation and consider cognitive assessment as part of routine follow-up. The findings support the potential for cognitive recovery post-treatment, emphasizing the importance of timely intervention and possibly tailored cognitive rehabilitation programs to improve patient outcomes and independence.
Conclusion
This study underscores the significant cognitive impact of CSDH and the need for systematic cognitive evaluation post-treatment. Further research is warranted to delineate long-term cognitive trajectories and optimize management strategies.
References
Author et al. 2024 -- Cognitive Outcomes in Patients with Chronic Subdural Hematoma Following Treatment: An Investigative Study
by Jurre Blaauw, Heleen M.den Hertog, Dana C. Holl, Nikki S. Thüss, Niels A. van der Gaag, Korné Jellema, Ruben Dammers, Kuan H. Kho, Rob J. M. Groen, Hester F. Lingsma, Bram Jacobs, Joukje van der Naalt
