The use of dexamethasone therapy for conservative management of chronic subdural hematomas: a question about efficacy and safety

Abstract Background Chronic subdural hematoma (CSDH) is a commonly encountered neurosurgical entity, particularly among the elderly population. Surgical intervention by trepanation or burr hole craniostomy remains gold standard approach for symptomatic cases. However, despite excellent outcome, surgical pathway also associated with possible complications, some of which might be fatal, in addition to recurrence rate up 25%. Dexamethasone (DXM) therapy was used as an alternative non-surgical approach, yet its clinical effectiveness controversial. Therefore, objective this study evaluate outcome DXM use management chronic hematomas regard results, safety, efficacy and potential incidence complications. Results This retrospective 30 patients, CSDH managed authors protocol. Subjects were assessed upon admission then closely monitored their response conservative management, followed data recorded at 2 weeks, 1 month, 3 months, 6 months after protocol initiation. Clinical scoring systems included Glasgow Coma Scale (GCS) Markwalder Grading (MGS), whereas radiological evaluation consisted serial Computerized tomography (CT)scans assess changes between time initiation over same intervals. There statistically highly significant improvement regarding GCS MGS studied cases on comparing starting values those throughout follow-up intervals six ( p = 0.001). Patients presented neurological deficit showed beginning our third month sixth Conclusions Our concluded that dexamethasone safe effective choice acceptable success low serious We do not advocate replacement surgery treatment but consider role selected Larger series further studies would considered longer periods.