For the cSDH conundrum and similar tough calls, it is indeed complicated, that's why one needs to stick to guidelines or expert opinion. If there are no clear instructions, then the attending's way is the highway. Or your gut feeling. The most important thing in this case is to document your decision and notify patient and relatives.
Hyper specialized internal med sub-subspecialist here.
I unequivocally agree with GP poster about the value of generalists. The systematic devaluation of internal medicine physicians (by this I mean not ABIM subspecialty boarded) is a tragedy.
(resident neurologist here) :)