1981 Volume 21 Issue 11 Pages 1153-1160
One hundred cases of chronic subdural hematoma, admitted during the past 2 years, were analyzed with CT scanning with respect to the clinical manifestation and the enlarging process of the hematoma. Their symptoms and signs, such as headache, motor paresis and mental disturbance, were not well correlated to the degree of the midline shift in CT scan, but rather to the patients' age. However, disturbed consciousness was more attributable to the midline shift or the intracranial mass effect. To investigate the mechanism of progressive development of chronic subdural hematoma, CT scan findings were classified into seven groups according to the density of the hematoma. In this study the morbid period of the patient was estimated from the onset of any clinical symptom and the clinical course of each patient was compared with the CT findings.
As a result, high density group and hematomas with niveau formation were found in cases of acute onset and, particularly, all of the clinical courses of niveau forming hematomas were of the apoplectiform type. All of the cases in low density group were observed within the range of 40 morbid days. Conversely, all of the cases with morbid periods longer than 40 days showed fluctuations of symptoms and the hematoma periods belonged to the isodensity group. It was considered that CT findings of the hematoma were dependent on the extent of capsular hemorrhage and the clinical course was probably diversified by the subsequent hemorrhagic process. Initially the hematoma space was seen in CT scans as a low density area, which later became high dense and then isodense as it matured.
