Publication:

Epidemiological profile, management and outcomes of chronic subdural hematoma in Ado-Ekiti, Nigeria

Background Chronic subdural hematoma (CSDH) is a common neurosurgical condition among older adults, with varied clinical presentations and outcomes. In resource-limited settings, understanding its epidemiology and treatment outcomes is important for improving patient care. Objective was to evaluate the epidemiological profile, clinical presentation, management strategies, and outcomes of patients with chronic subdural hematoma in Ado-Ekiti, Nigeria.

Methods This retrospective descriptive and analytical study included patients managed for CSDH at a tertiary hospital between January 2022 and December 2025. Data were extracted from medical records and analyzed using SPSS version 25. Variables assessed included socio-demographic characteristics, clinical features, radiological findings, treatment modalities, and outcomes. Logistic regression identified predictors of poor outcome, defined as death or lack of clinical improvement at discharge.

Results A total of 187 patients were studied. The mean age was 66.4±12.8 years, with males accounting for 71.7% of cases. Head trauma occurred in 75.9%, mainly from falls (54.9%). Headache (79.7%) and hemiparesis (63.1%) were the most common symptoms. Surgical treatment was performed in 79.7%, predominantly via burr hole drainage (81.2%). Full recovery occurred in 51.9%, while mortality was 8.6%. Predictors of poor outcome included age ≥70 years, severe Glasgow Coma Scale score at presentation, bilateral hematoma, and midline shift, whereas surgical treatment was protective.

Conclusions CSDH predominantly affects elderly males and is commonly associated with minor head trauma. Early diagnosis and timely surgical intervention are associated with favorable outcomes.