Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.
Center for Medical Decision Sciences, Department of Public Health, Erasmus Medical Center, Rotterdam, Netherlands.
Acta Neurochir (Wien). 2023 Mar;165(3):701-709. doi: 10.1007/s00701-023-05508-7. Epub 2023 Feb 8.
Chronic subdural hematoma (CSDH) is a common neurological condition, often affecting the elderly. Cognitive impairment is frequently observed at presentation. However, the course and longer term aspects of the cognitive status of CSDH patients are unknown. In this study, we aim to explore the cognitive status of CSDH patients after treatment.
An exploratory study in which CSDH patients were assessed 3 months after treatment and compared to healthy controls. A total of 56 CSDH patients (age 72.1 SD ± 10.8 years with 43 [77%] males) and 60 healthy controls were included (age 67.5 ± SD 4.8 with 34 [57%] males). Cognitive testing was performed using the Telephonic Interview of Cognitive Status-modified (TICS-m), a 12-item questionnaire in which a total of 50 points can be obtained on several cognitive domains.
Median time between treatment and cognitive testing was 93 days (range 76-139). TICS-m scores of CSDH patients were significantly lower than healthy controls, after adjusting for age and sex: mean score 34.6 (95% CI: 33.6-35.9) vs. 39.6 (95% CI: 38.5-40.7), p value < 0.001. More than half (54%) of CSDH patients have cognitive scores at follow-up that correspond with cognitive impairment.
A large number of CSDH patients show significantly worse cognitive status 3 months after treatment compared to healthy controls. This finding underlines the importance of increased awareness for impaired cognition after CSDH. Further research on this topic is warranted.
慢性硬脑膜下血肿（CSDH）是一种常见的神经疾病，常发生于老年人。发病时通常会出现认知障碍。然而，CSDH 患者的认知状态的病程和长期方面尚不清楚。在这项研究中，我们旨在探讨 CSDH 患者治疗后的认知状态。
这是一项探索性研究，对治疗后 3 个月的 CSDH 患者进行评估，并与健康对照组进行比较。共纳入 56 例 CSDH 患者（年龄 72.1 ± 10.8 岁，男性 43 例[77%]）和 60 例健康对照组（年龄 67.5 ± 4.8 岁，男性 34 例[57%]）。认知测试采用电话访谈认知状态修改版（TICS-m）进行，该测试包含 12 个项目，总分为 50 分，可评估多个认知域。
治疗与认知测试之间的中位时间为 93 天（范围 76-139）。校正年龄和性别后，CSDH 患者的 TICS-m 评分明显低于健康对照组：平均得分为 34.6（95%CI：33.6-35.9）比 39.6（95%CI：38.5-40.7），p 值<0.001。超过一半（54%）的 CSDH 患者在随访时的认知评分对应于认知障碍。
与健康对照组相比，大量 CSDH 患者在治疗后 3 个月表现出明显更差的认知状态。这一发现强调了对 CSDH 后认知障碍提高认识的重要性。需要进一步研究这一课题。
