REVIEW
Introdução: as manifestações clínicas do hematoma subdural crônico (HSDC) são frequentemente confundidas com outras entidades médicas no idoso, dificultando seu diagnóstico precoce. Por sua vez, o diagnóstico precoce é importante pelo seu prognóstico estar diretamente associado ao estado neurológico pré-operatório, repercutindo, assim, em um pior prognóstico vital e funcional. Objetivo: relatar através de uma revisão da literatura as manifestações clínicas do HSDC na população idosa. Métodos: revisão da literatura, com os termos de busca: Hematoma Subdural Crônico; Idoso; Sinais e sintomas e Prognóstico nas bases de dados PubMed, Lilacs, Scielo, Cochrane e TripDataBase. Os critérios de inclusão foram estudos originais publicados em qualquer idioma. Foram excluídos aqueles impossibilitados de leitura completa. Após a aplicação dos critérios de inclusão e exclusão, 111 artigos foram incluídos no estudo. Resultados: apresentação clínica depende da localização, volume do hematoma, rapidez no crescimento, a localização do HSDC, sendo uni ou bilateral, e das condições clínicas do paciente. Devido às formas de apresentação clínica do HSDC apresentarem-se variáveis, é necessário que os profissionais de saúde ligados aos idosos (geriatra, psiquiatra e clínico geral) tenham conhecimento desta entidade clínica. Conclusão: O reconhecimento das formas clássicas, assim como a identificação dos fatores de risco em idosos, favorece o diagnóstico e tratamento adequado em tempo hábil do HSDC na população idosa.
Introduction: the clinical manifestations of chronic subdural hematoma (HSDC) are often confounded with other medical conditions in the elderly, making its early diagnosis difficult. Early diagnosis is important, since its prognosis is directly associated with the preoperative neurological status, thus resulting in a worse vital and functional prognosis. Objective: to report, through a literature review, the clinical manifestations of HSDC in the elderly population. Methods: Literature review using as search terms: Chronic subdural hematoma; Elderly; Signs and symptoms and Outcome in PubMed, Lilacs, Scielo, Cochrane and TripDataBase databases. Inclusion criteria were original studies published in any language. Articles in which full reading was not possible were excluded. After inclusion and exclusion criteria, 111 articles were included in the study. Results: clinical presentation depends on the location, volume of the hematoma, rapid growth, location of the HSDC, whether uni or bilateral, and clinical condition of the patient. Due to the variable forms of clinical presentation of the HSDC, it is mandatory to the health professionals linked to the elderly (geriatricians, psychiatrists and general practitioners) to be aware of this clinical entity. Conclusion: the recognition of the classic forms as well as the identification of risk factors in the elderly favors the diagnosis and timely treatment of HSDC in this population.
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(1) MD, PhD, Neurosurgeon, Neurosurgery Service, Sergipe Emergency Hospital – HUSE, Aracaju (SE), Brazil.
(2) MD, PhD, Professor, Department of Medicine, Federal University of Sergipe – UFS, Aracaju (SE), Brazil.
(3) Medicine student, Federal University of Paraná – UFPR, Curitiba (PR), Brazil.
(4) MSc, PhD, Nurse, Vice-President, Brasilian Association of Nursing in Neurology and Neurosurgery, Aracaju (SE), Brazil.
(5) MD, Neurosurgeon, Departament of Neurosurgery, Faculty of Medicine, Atenas University Center – UniAtenas, Paracatu (MG), Brazil.
Received May 17, 2021
Corrected Aug 9, 2021
Accepted Aug 10, 2021
