Chronic Subdural Hematoma as a Potentially Reversible Cause of Cognitive and Gait Decline in Older Adults: Clinical Recognition, Treatment, and Functional Recovery
5 affiliations
- 1Faculty of Medicine, Collegium Medicum, The Mazovian University in Płock, 09-402 Płock, Poland
- 2Department of Neurology and Neurosurgery, Faculty of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, Aleja Warszawska 30, 10-082 Olsztyn, Poland
- 3Department of Nursing, Faculty of Health Sciences, Collegium Medicum, The Mazovian University in Płock, 09-402 Płock, Poland
- 4Department of Neurosurgery, Neurotraumatology and Spinal Surgery, Regional Hospital in Elblag, 82-300 Elblag, Poland
- 5Faculty of Health Science, Collegium Medicum, The Mazovian University in Płock, 09-402 Płock, Poland
Abstract
Chronic subdural hematoma (cSDH) is an increasingly common neurological disorder in older adults and may present with cognitive decline, gait instability, recurrent falls, and loss of independence rather than overt focal deficits. Because these symptoms overlap with dementia, delirium, parkinsonism, and frailty, diagnosis may be delayed despite the potential for meaningful recovery after treatment. This narrative review summarizes evidence on clinical recognition, treatment, early mobilization, rehabilitation, and patient-centered recovery in older adults with cSDH. A targeted search of PubMed/MEDLINE, Scopus, and Web of Science identified randomized trials, observational studies, systematic reviews, meta-analyses, guidelines, and consensus statements available through July 2026. Surgical decompression may improve cognition and mobility, but the magnitude and durability of recovery vary. Premorbid cognitive and functional status, frailty, malnutrition, postoperative delirium, and complications are associated with outcomes, although causal effects are incompletely established. Postoperative drainage reduces recurrence; selected randomized trials suggest that middle meningeal artery embolization reduces recurrence or treatment failure, whereas evidence for independent cognitive and gait benefits remains limited. Early mobilization may reduce medical complications. Evidence specific to cSDH remains insufficient to prescribe a standardized exercise dose or progression. Multidimensional follow-up and prospective trials using cognitive, gait, quality-of-life, and participation outcomes are needed to determine whether successful hematoma treatment translates into restored independence and meaningful daily function.
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BibTeX
@article{kuczynski2026chronic,
title = {{Chronic Subdural Hematoma as a Potentially Reversible Cause of Cognitive and Gait Decline in Older Adults: Clinical Recognition, Treatment, and Functional Recovery}},
author = {Nikodem Kuczyński and Mariusz Sowa and Mariola Głowacka and Edyta Zomkowska and Dawid Pilewski},
journal = {Journal of Clinical Medicine},
year = {2026},
month = nov,
doi = {10.3390/jcm15218605},
url = {https://www.mdpi.com/2077-0383/15/21/8605},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Chronic Subdural Hematoma as a Potentially Reversible Cause of Cognitive and Gait Decline in Older Adults: Clinical Recognition, Treatment, and Functional Recovery
AU - Nikodem Kuczyński
AU - Mariusz Sowa
AU - Mariola Głowacka
AU - Edyta Zomkowska
AU - Dawid Pilewski
PY - 2026
DA - 2026/11/04
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15218605
UR - https://www.mdpi.com/2077-0383/15/21/8605
AB - Chronic subdural hematoma (cSDH) is an increasingly common neurological disorder in older adults and may present with cognitive decline, gait instability, recurrent falls, and loss of independence rather than overt focal deficits. Because these symptoms overlap with dementia, delirium, parkinsonism, and frailty, diagnosis may be delayed despite the potential for meaningful recovery after treatment. This narrative review summarizes evidence on clinical recognition, treatment, early mobilization, rehabilitation, and patient-centered recovery in older adults with cSDH. A targeted search of PubMed/MEDLINE, Scopus, and Web of Science identified randomized trials, observational studies, systematic reviews, meta-analyses, guidelines, and consensus statements available through July 2026. Surgical decompression may improve cognition and mobility, but the magnitude and durability of recovery vary. Premorbid cognitive and functional status, frailty, malnutrition, postoperative delirium, and complications are associated with outcomes, although causal effects are incompletely established. Postoperative drainage reduces recurrence; selected randomized trials suggest that middle meningeal artery embolization reduces recurrence or treatment failure, whereas evidence for independent cognitive and gait benefits remains limited. Early mobilization may reduce medical complications. Evidence specific to cSDH remains insufficient to prescribe a standardized exercise dose or progression. Multidimensional follow-up and prospective trials using cognitive, gait, quality-of-life, and participation outcomes are needed to determine whether successful hematoma treatment translates into restored independence and meaningful daily function.
SN - 2077-0383
ER -