Nonsurgical Treatment of Chronic Subdural Hematoma with Steroids

World Neurosurgery
Amit Kumar Thotakura, Nageswara Rao Marabathina

Abstract

Some studies demonstrated the role of steroids in medical management of chronic subdural hematoma (CSDH). Aim of our study is to evaluate the role of steroids in medical treatment of CSDH and to evaluate the subgroup of patients who respond to steroids. This prospective case study was done for 26 months from April 2013 to May 2015. On admission, the parenteral steroid dexamethasone (4 mg) was given every 8 hours for 72 hours. If the patient improved, the oral tapering doses of steroids were continued for 1 month. Neurological assessment and computed tomography scan done after 6 weeks. If the patient had not improved at 72 hours, a standard burr hole and evacuation was done. Twenty-six consecutive patients were studied (20 men; mean age, 60.25 years). The average thickness of the hematoma was 21.9 mm, the mean midline shift was 10.3 mm, and the average attenuation value of bleed on computed tomography scan was 35.7. Eleven patients were treated successfully with steroid treatment, whereas 15 patients required surgery. The female gender, less midline shift, less density (Hounsfield units) were noted to be associated with successful medical treatment. We propose a grading based on the total score given to the midline shift and den...Continue Reading

References

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Citations

Aug 28, 2016·World Neurosurgery·Amit Kumar Thotakura, Nageswara R Marabathina
Jan 14, 2017·Journal of Neurosurgery·Chinmaya Dash, Raghav Singla
Jun 28, 2017·Neurologia Medico-chirurgica·Masaaki UnoSatoshi Hirai
Nov 30, 2018·Journal of Korean Neurosurgical Society·Kyeong-Seok Lee
Feb 25, 2019·Journal of Neurointerventional Surgery·David Fiorella, Adam S Arthur
Nov 19, 2019·Translational Neuroscience·Zbigniew KotwicaIreneusz Dziuba
Feb 7, 2020·Acta neurochirurgica·E EdlmannUNKNOWN International Collaborative Research Initiative on Chronic Subdural Haematoma (iCORIC) study group
Jun 1, 2017·Journal of Neuroinflammation·Ellie EdlmannPeter J Hutchinson
Oct 12, 2017·Radiology·Seung Pil BanChang Wan Oh
Apr 12, 2019·Scientific Reports·Ellie EdlmannUNKNOWN Dex-CSDH trial collaborative and BNTRC collaborative.
Feb 3, 2021·Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences·Joshua DianJai Js Shankar
Nov 17, 2020·Frontiers in Neurology·Joshua S CatapanoAndrew F Ducruet
Feb 21, 2021·Clinical Neurology and Neurosurgery·Dongdong WangCunzu Wang
May 18, 2018·World Neurosurgery·Dana C HollUNKNOWN Dutch Chronic Subdural Hematoma Research Group (DSHR)
Sep 21, 2021·The Journal of Trauma and Acute Care Surgery·Michael T BounajemRamesh Grandhi

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