QUALITY OF LIFE IN PATIENTS WITH CHRONIC SUBDURAL HEMATOMAS DEPENDING ON DIFFERENT TREATMENT MODALITIES

Abstract

Background. Chronic subdural hematoma (CSDH) is one of the most common neurosurgical conditions and is generally associated with a favorable prognosis when treated appropriately. Nevertheless, long-term functional outcomes and quality of life remain insufficiently investigated.
Objective. To evaluate long-term quality of life in patients with CSDH depending on different treatment modalities.
Materials and Methods. The study included 338 patients with CSDH (mean age 49.6±1.6 years). All patients underwent CT and/or MRI of the brain. Clinical course and long-term outcomes were analyzed with a follow-up period of up to 10 years. Functional outcomes and quality of life were assessed using the Karnofsky Performance Status scale.
Results. Minimally invasive surgical treatment with closed external drainage was performed in 89% of cases, craniotomy in 1%, and conservative management in 10%. Good recovery was achieved in 84.5% of patients, moderate disability in 12.2%, and severe disability in 2.1%. Overall mortality was 1.2%. No recurrences of CSDH were observed during long-term follow-up. Return to work, education, or normal daily activities was achieved in 89.8% of patients.
Conclusion. Adequate treatment of chronic subdural hematoma leads to favorable long-term outcomes and high quality of life in the majority of patients. Residual disability is mainly associated with age-related changes and severe consequences of traumatic brain injury rather than with the hematoma itself.