ArticleActa neurochirurgica2025
What happens to conservatively managed chronic subdural haematoma.
Article in Acta neurochirurgica, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
2 citing papers in PubMed.
- Regional Geriatric Trauma Advice for Older Patients with Chronic Subdural Haematoma-A Novel Service for Multi-Disciplinary Decision-Making.Geriatrics (Basel, Switzerland) · 2026Article
- Atorvastatin accelerates hematoma absorption and ameliorates cognitive impairment in patients with chronic subdural hematoma complicated by cognitive dysfunction: a retrospective analysis.Frontiers in pharmacology · 2026Article
Corrections and comments
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundChronic subdural haematoma (CSDH) is a common neurosurgical problem, increasingly prevalent due to an ageing population. Conservative management is an option for asymptomatic or mild cases, though data on outcomes is limited. AIM/
objectiveThis study aims to address critical gaps in understanding around conservatively managedCSDH and whether there are features that can predict progression and the longer-term prognosis of these patients.
methodsA retrospective cohort study was performed at a major trauma centre in the UK. All patients with chronic subdural haematoma referred from March 2019 to March 2021 were included and grouped into surgical or conservative management. Demographic, outcome, and radiological data were collected from patient records and compared.
resultsOf 289 patients, 90 had surgery and 199 were managed conservatively. Conservative patients were older (84 vs 77 years, p < 0.0001), had more comorbidities (4 vs 2, p < 0.0001), higher frailty (CFS > 6: 45% vs 10%, p < 0.0001), and greater anti-thrombotic use (57% vs 42%, p = 0.0175). Mortality was significantly higher in the conservative group at all time points including one month (16% vs 2%, p < 0.0001), one year (42% vs 12%, p < 0.0001) and two years (55% vs 21%, P < 0.0001). Surgical patients had significantly greater midline shift (10 mm vs 2.6 mm, p < 0.0001), and haematoma depth (24 mm vs 11 mm, p < 0.0001). Only 3% of conservative patients crossed over to surgery.
conclusionOur study highlights the high mortality rate in conservatively managed CSDH, with frailty as a key indicator for early death. The low crossover to surgery questions the necessity of radiological monitoring in conservatively managed CSDH.
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