Effects of dexamethasone in the treatment of recurrent chronic subdural hematoma.

Effects of dexamethasone in the treatment of recurrent chronic subdural hematoma.

World Neurosurg. 2017 May 31;:

Authors: Zhang Y, Chen S, Xiao Y, Tang W

Abstract
OBJECTIVE: Recurrent chronic subdural hematoma (CSDH) is not rare. Some studies have demonstrated the role of dexamethasone in the medical management of chronic subdural hematoma. However, no systematic study in the treatment of recurrent CSDH has been published. The aim of our study is to evaluate the efficacy and safety of dexamethasone in patients with recurrent CSDH.
METHODS: We retrospectively reviewed medical records of consecutive patients from July 2010 to September 2014. A total of 27 patients with symptomatic recurrent CSDH -were included in the analysis. Follow-up for each patient consisted of CT or MRI every 28 days from admission to the resolution of hematoma. Data was collected on hematoma volume, complications, and outcome.
RESULTS: Among the 27 patients, 3 patients with recurrent CSDH were only treated by burr hole surgery. Of the other 24 patients who primarily underwent dexamethasone treatment, 17 (70.8%) patients were treated successfully with medical treatment, whereas 7 patients required reoperation. Complications were noted in 3(12.5%) patients (1 hyperglycemia, 1 urinary infect and 1 pneumonia). There was 1 mortality (4.2%) for massive brain infarction. Twenty-one of the 24 patients (87.5%) recovered to their previous functional levels. There was no statistical significance in Fisher's text between surgery and dexamethasone regarding success, complication, functional recovery rate.
CONCLUSIONS: Patients with recurrent CSDH can be treated successfully and safely with the nonsurgical medical treatment of dexamethasone. By use of this method, reoperation may be avoided.

PMID: 28578110 [PubMed - as supplied by publisher]

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