DOI: https://doi.org/10.22263/2312-4156.2026.2.33
Y.O. Ryabchikova1, Y.G. Shanko2
Chronic subdural hematoma: current state of the problem
1Vitebsk Regional Clinical Hospital, Vitebsk, Republic of Belarus
25th City Clinical Hospital, Minsk, Republic of Belarus
Vestnik VGMU. 2026;25(2):33-42.
Abstract.
Chronic subdural hematoma (CSDH) is one of the most common neurosurgical conditions in elderly patients. Its increasing incidence is due to the aging of the population, the high prevalence of traumatic brain injury, and the increasing number of patients receiving long-term anticoagulant and antiplatelet therapy. The clinical manifestations of CSDH are variable and nonspecific, often have a long latency period, and can mimic other central nervous system diseases, complicating timely diagnosis.
This article presents a current review of the literature on the epidemiology, pathophysiology, clinical presentation, diagnosis, and treatment of chronic subdural hematoma. Particular attention is paid to neuroimaging techniques, such as computed tomography and magnetic resonance imaging, as well as morphological classifications of chronic subdural hematoma, including the Nakaguchi classification and its modifications, which have prognostic significance.
Current approaches to the treatment of CSDH are reviewed, including dynamic observation, surgical hematoma drainage using various drainage options, and the role of adjuvant and alternative treatments. The indications and limitations of corticosteroids, drug therapy, and endovascular embolization of the middle meningeal artery are analyzed.
This review reflects current trends in the diagnosis and treatment of CSDH and highlights the need for further high-quality clinical research to develop standardized recommendations.
Keywords: chronic subdural hematoma, computed tomography, Nakaguchi classification, hematoma capsule, surgical treatment, risk factors for recurrence, conservative treatment, prognosis.
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Submitted 16.03.2026
Accepted 14.04.2026
Information about authors:
Yulia O. Ryabchikova – neurosurgeon of the Neurosurgical Department, Vitebsk Regional Clinical Hospital, post-graduate of the Republican Scientific and Practical Centre of Neurology and Neurosurgery, e-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра.;
Y.G. Shanko – Doctor of Medical Sciences, professor, corresponding member of NAS of Belarus, head of the Department of Neurology and Neurosurgery, 5th City Clinical Hospital, Minsk.
