Chronic Subdural Hematomas of Thies Hospital Center: About 102 Cases

Introduction: The chronic subdural hematoma is a hematic collection built up over several weeks and located between the dura mater and the arachnoid. It is a common condition in geriatric patients, most often following a head injury, sometimes minimal that goes unnoticed. The objective of this study is to give the clinical, therapeutic and evolutionary aspects of chronic subdural hematomas in our department. Patients and Methods: this is a retrospective, descriptive study of 102 cases of chronic subdural hematomas hospitalized in the Neurosurgery Department of the Regional Hospital of Thiès in Senegal over a period of 05 years from January 2016 to January 2021. Results: A total of 102 cases of chronic subdural hematomas were identified. The mean age was 66 years with extremes of 25 and 91 years. The sex ratio was 4.6. A notion of minimal head trauma was found in 59% of cases. The use of salicylates was found in 12% of cases and 05% of patients were on anticoagulant treatment. Motor deficit was the main telltale sign (79.41% of cases), followed by headache in 35.29% of cases. Subdural hematoma was bilateral in 23 (22.54%) of patients and unilateral in 79 (77.45%) of patients with a predominance of the left side in 51 (50%) cases. Five of our patients benefited from exclusive medical treatment with a good evolution Among the 95 patients operated, 82% of the patients were operated on under general anesthesia and only 18% under local anesthesia. The drill hole technique was the most commonly used, i.e. 96% of the patients operated on except for 4 patients who had a cranial flap. The short- and medium-term evolution was favorable in 75% of patients with a complete recovery in 80.39%. The mortality rate in our study was 9%. Ten (10) patients had sequelae after surgical treatment. Conclusion: Chronic subdural hematoma is a common pathology in the elderly. Its prognosis is good if diagnosed and treated early.