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Review
. 2018 Oct-Dec;13(4):976-983.
doi: 10.4103/ajns.AJNS_13_17.

The Role of Medical Treatment in Chronic Subdural Hematoma

Amit Kumar Thotakura  1 , Nageswara Rao Marabathina  1
Affiliations
Review

The Role of Medical Treatment in Chronic Subdural Hematoma

Amit Kumar Thotakura et al. Asian J Neurosurg. 2018 Oct-Dec.

Abstract

Surgery is the standard treatment for chronic subdural hematoma (CSDH), one of the common problems in neurosurgical practice. Although medical treatment was used by some authors and found some positive results, it is not accepted by many authors. The aim of this review is to give overall view of the medical management of CSDH. Action of various drugs in the pathophysiological cascade of formation of CSDH was depicted. The review of literature is done under three headings - the primary medical treatment of CSDH, adjuvant medical treatment with surgery, and the treatment of the recurrence. Various classifications of CSDH and the factors influencing the outcome of medical treatment are discussed. There is a role of medical treatment in a selected group of patients with CSDH. Well-designed, multicenter, randomized controlled trials are required to define the indications and standard protocols for the medical treatment of CSDH.

Keywords: Chronic subdural hematoma; classification of chronic subdural hematoma; conservative management; medical treatment; nonsurgical treatment.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
The cascade of events that occur in the formation of chronic subdural hematoma and drugs acting at various stages
Figure 2
Figure 2
Mechanism of action of steroids in the treatment of chronic subdural hematoma
See this image and copyright information in PMC

References

    1. Kageyama H, Toyooka T, Tsuzuki N, Oka K. Nonsurgical treatment of chronic subdural hematoma with tranexamic acid. J Neurosurg. 2013;119:332–7. - PubMed
    1. Hirashima Y, Kurimoto M, Nagai S, Hori E, Origasa H, Endo S. Effect of platelet-activating factor receptor antagonist, etizolam, on resolution of chronic subdural hematoma – A prospective study to investigate use as conservative therapy. Neurol Med Chir (Tokyo) 2005;45:621–6. - PubMed
    1. Wang D, Li T, Tian Y, Wang S, Jin C, Wei H, et al. Effects of atorvastatin on chronic subdural hematoma: A preliminary report from three medical centers. J Neurol Sci. 2014;336:237–42. - PubMed
    1. Bender MB, Christoff N. Nonsurgical treatment of subdural hematomas. Arch Neurol. 1974;31:73–9. - PubMed
    1. Pichert G, Henn V. Conservative therapy of chronic subdural hematomas. Schweiz Med Wochenschr. 1987;117:1856–62. - PubMed