Our group recently treated two elderly male patients with chronic subdural hematoma on one side and chronic subdural effusion on the other, one 80 years old and one 85 years old. Both had severe brain atrophy. The combined treatment approach we adopted had previously proven successful in 15 patients. In contrast, the 82-year-old had pre-existing dementia and a history of multiple minor head injuries from falls. After admission, he was still superficially conscious, but on the 4th day, he became more conscious, and the diagnosis was confirmed by a repeat CT scan of a suspected chronic subdural fluid. However, fever started after the operation, with a temperature of 40 degrees at one point, and Acinetobacter baumannii pneumonia was confirmed 1 week later, but the consciousness continued to deteriorate. The previous protocol for treatment of A. baumannii was used, and the combination of immunomodulation plus angiogenesis was continued. The patient was completely awake and verbal on day 15. Sputum culture for Acinetobacter baumannii turned small. Blood count was normal, and the lung infection foci were significantly improved. Head CT review, the hematoma had disappeared and the effusion was as preoperative …… The patient was discharged for recuperation; a 5-year-old man from Dacheng, Hebei, with a clear history of fall injury. Before the onset of the disease, he could lift 50 kg of grain, but after the onset of the disease, he needed crutches or bystander support to walk, and was unable to walk independently; the headache and dizziness were most obvious in the occipital region and were associated with changes in head position. The head CT and MRI both showed bilateral occupancy, the right hematoma was greater than 90 ml, and the left density showed effusion, which was more than 100 ml. The same family refused surgery. After 3 days, the patient’s symptoms were significantly relieved and he was transferred to the floor. 12 days later, the head CT was reexamined: compared with the original CT film, only 1/2 of the right hematoma remained; the left effusion was almost unchanged. The patient’s headache has disappeared, and he is free to go down to the ground and live his life basically as usual. Because the patient’s wife came to our hospital from Hebei to visit the patient with ketoacidosis and weakness, our patient firmly requested to be discharged to continue treatment. He was discharged with medication and followed up regularly. This treatment experience: Surgical treatment of chronic subdural effusion or hematoma in the elderly carries the risk of complications. Our 82-year-old patient in this case almost turned dangerous. Conservative treatment may allow the patient to return to life and work more quickly than aggressive surgery. For chronic subdural hematoma in the elderly, please choose your surgery carefully~ Moreover, for elderly patients with chronic subdural hematoma, about half of the hematoma is absorbed and their main signs and symptoms return to normal, so you can handle the other half of the hematoma or effusion without haste. In the elderly, the main treatment must be a conservative one.