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CHRONIC SUBDURAL HEMATOMA : A REVERSIBLE CAUSE OF DEMENTIA
Piers R., Van Den Noortgate N., Petrovic M., Michielsen W.
INTRODUCTION
Dementia has profound effects on the patient and his/her environment and is associated with high use and costs of medical care. Therefore, the identification of potentially reversible causes of dementia is essential.
The insidious onset of symptoms in chronic subdural hematoma (CSH) is sometimes interpreted as dementia. Literature review on this topic shows only a few reports focusing on neuropsychiatric functions in patients with CSH. These reports also show little prove of cognitive improvement after neurosurgery.
CASE REPORT
A case of a 76-year-old woman with overt deterioration of cognitive functioning over a period of a couple of months is described. Relevant past medical history consists of a cerebrovascular accident in 2002 with right hemiplegia and good recovery for which she is on antiplateled medication. On the mini mental state examination (MMSE) the patient scored 16/30. CT scan of the brains reveals a CSH with mass-effect and an old ischaemic lesion. After burr hole irrigation, serial assessment of cognitive functions by means of MMSE show progressive improvement of the mental status. The patient was discharged from hospital with a MMSE-score of 24/30.
CONCLUSION
In this case report, an obvious improvement in neuropsychiatric functions after burr hole irrigation in a 76-year-old woman with chronic subdural hematoma is seen.
In an ageing population with increasing usage of antithrombotic therapy, chronic subdural hematoma should receive greater attention as a potential cause of reversible dementia.
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