AI Summary & Key Takeaways
AI InsightClinical features and collection thickness alone were insufficient for reliable differentiation, underscoring the importance of careful neuroradiological evaluation, supported when necessary by magnetic resonance imaging or other advanced imaging modalities.
📌 3 Key Takeaways
Abstract
This study aimed to evaluate the role of subdural effusion in the differential diagnosis of subdural fluid collections referred from the emergency department with suspected chronic subdural hematoma and to identify the clinical and radiological features that may aid this distinction. In this single-center retrospective study, 17 adult patients referred for neurosurgical consultation with an initial diagnosis of chronic subdural hematoma who were subsequently diagnosed with subdural effusion were reviewed. Demographic characteristics, trauma history, presenting symptoms, admission Glasgow Coma Scale scores, emergency cranial computed tomography findings, and collection thickness were obtained from medical records. Five patients were classified as having traumatic subdural effusion and 12 as having non-traumatic subdural effusion. The mean age was 77.6 years in the traumatic group and 78.4 years in the non-traumatic group, and 13 patients (76.4%) were male. Admission Glasgow Coma Scale scores were predominantly 15 in both groups, and mean collection thicknesses were similar (8.8 mm vs. 8.3 mm). Most clinically stable patients without midline shift did not require surgical intervention, whereas emergent surgery was performed in one patient because of neurological deficit and computed tomography evidence of midline shift. These findings suggest that, among older adults referred from the emergency department with suspected chronic subdural hematoma, some subdural fluid collections may actually represent subdural effusion, highlighting the potential for overdiagnosis of chronic subdural hematoma in emergency practice. Clinical features and collection thickness alone were insufficient for reliable differentiation, underscoring the importance of careful neuroradiological evaluation, supported when necessary by magnetic resonance imaging or other advanced imaging modalities.
Özet
This study aimed to evaluate the role of subdural effusion in the differential diagnosis of subdural fluid collections referred from the emergency department with suspected chronic subdural hematoma and to identify the clinical and radiological features that may aid this distinction. In this single-center retrospective study, 17 adult patients referred for neurosurgical consultation with an initial diagnosis of chronic subdural hematoma who were subsequently diagnosed with subdural effusion were reviewed. Demographic characteristics, trauma history, presenting symptoms, admission Glasgow Coma Scale scores, emergency cranial computed tomography findings, and collection thickness were obtained from medical records. Five patients were classified as having traumatic subdural effusion and 12 as having non-traumatic subdural effusion. The mean age was 77.6 years in the traumatic group and 78.4 years in the non-traumatic group, and 13 patients (76.4%) were male. Admission Glasgow Coma Scale scores were predominantly 15 in both groups, and mean collection thicknesses were similar (8.8 mm vs. 8.3 mm). Most clinically stable patients without midline shift did not require surgical intervention, whereas emergent surgery was performed in one patient because of neurological deficit and computed tomography evidence of midline shift. These findings suggest that, among older adults referred from the emergency department with suspected chronic subdural hematoma, some subdural fluid collections may actually represent subdural effusion, highlighting the potential for overdiagnosis of chronic subdural hematoma in emergency practice. Clinical features and collection thickness alone were insufficient for reliable differentiation, underscoring the importance of careful neuroradiological evaluation, supported when necessary by magnetic resonance imaging or other advanced imaging modalities.