Yu Zhang1, Shiping Chen1, Yangchun Xiao1, Wenhua Tang2. 1. Department of Neurosurgery, Affiliated Hospital of Chengdu University, Chengdu, Sichuan, China. 2. Department of Neurosurgery, Affiliated Hospital of Chengdu University, Chengdu, Sichuan, China. Electronic address: 48295109@qq.com.
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 computed tomography or magnetic resonance imaging every 28 days from admission to the resolution of hematoma. Data were 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 tract infection, 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 text between surgery and dexamethasone regarding success, complication, and 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.
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 computed tomography or magnetic resonance imaging every 28 days from admission to the resolution of hematoma. Data were 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 tract infection, 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 text between surgery and dexamethasone regarding success, complication, and 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.
Authors: Rong Cai Jiang; Dong Wang; Shi Guang Zhao; Ren Zhi Wang; De Zhi Kang; Xin Gen Zhu; Zong Mao Zhao; Jun Ji Wei; Ying Huang; Yan Qu; Xiao Chuan Sun; Hong Ming Ji; Xiao Chun Jiang; Jin Fang Liu; Xi De Zhu; Jian Jun Wang; Ye Tian; Chuang Gao; Hui Jie Wei; Shu Zhang; Wei Quan; Shu Yuan Yue; Ping Lei; Xian Li; Li Li Song; Craig S Anderson; Jian Ning Zhang Journal: Trials Date: 2021-12-11 Impact factor: 2.279