Format

Send to

Choose Destination
J Korean Neurosurg Soc. 2016 Nov;59(6):628-636. Epub 2016 Oct 24.

Spontaneous Resolution of Chronic Subdural Hematoma : Close Observation as a Treatment Strategy.

Author information

1
Department of Neurological Surgery, College of Medicine, Dankook University, Cheonan, Korea.
2
Department of Radiology, College of Medicine, Dankook University, Cheonan, Korea.

Abstract

OBJECTIVE:

Chronic subdural hematoma (cSDH) is common condition in neurosurgical field. It is difficult to select the treatment modality between the surgical method and the conservative method when patients have no or mild symptoms. The purpose of this study is to provide a suggestion that the patients could be cured with conservative treatment modality.

METHODS:

We enrolled 16 patients who had received conservative treatment for cSDH without special medications which could affect hematoma resolution such as mannitol, steroids, tranexamic acid and angiotensin converting enzyme inhibitors. The patients were classified according to the Markwalder's Grading Scale.

RESULTS:

Among these 16 patients, 13 (81.3%) patients showed spontaneously resolved cSDH and 3 (18.7%) patients received surgery due to symptom aggravation and growing hematoma. They were categorized into two groups based on whether they were cured with conservative treatment or not. The first group was the spontaneous resolution group. The second group was the progression-surgery group. The mean hematoma volume in the spontaneous resolution group was 43.1 mL. The mean degree of midline shift in the spontaneous resolution group was 5.3 mm. The mean hematoma volume in the progression-surgery group was 62.0 mL. The mean degree of midline shift in the second group was 6 mm.

CONCLUSION:

We suggest that the treatment modality should be determined according to the patient's symptoms and clinical condition and close observation could be performed in patients who do not have any symptoms or in patients who have mild to moderate headache without neurological deterioration.

KEYWORDS:

Chronic subdural hematoma; Close observation; Treatment

Supplemental Content

Full text links

Icon for Publishing M2Community Icon for PubMed Central
Loading ...
Support Center