A chronic subdural hematoma can occur at any age but is usually a problem in the elderly.
A chronic subdural hematoma may be associated with:
(1) focal neurological findings
(2) personality change
(3) cognitive impairment, including dementia
(4) headache
(5) somnolence
(6) asthenia (lack of energy and/or strength)
Findings that may suggest the diagnosis:
(1) history of fall or head injury
(2) bruising
(3) anticoagulation therapy
(4) bleeding disorder
Reasons the diagnosis may be missed or delayed:
(1) imaging studies not performed
(2) head trauma considered insignificant or denied
(3) spontaneous bleed
(4) history unreliable (patient confused)
(5) findings ascribed to another disorder (heart failure, stroke, etc)
(6) assumption that cognitive impairment is dementia
(7) area of bruising or injury hidden by hair
