THE USEFULNESS OF DEXAMETHASONE IN THE TREATMENT OF
CHRONIC SUBDURAL HEMATOMAS
TOMA PAPACOCEA 1#*, EMIL POPA 2#, TURLIUC DANA 3#, RALUCA PAPACOCEA 4
1Department of Neurosurgery, “Sf. Pantelimon” Emergency Hospital, 340 Pantelimon Road, Bucharest, Romania
2Department of Neurosurgery, “Dr. Carol Davila” Central Military Emergency University Hospital, 134 Calea Plevnei
Street, Bucharest, Romania
3Department of Neurosurgery, “N. Oblu” Hospital, “Gr. T. Popa” University of Medicine and Pharmacy, Iași, Romania
4Department of Physiology, “Carol Davila” University of Medicine and Pharmacy, Faculty of Medicine, 8 Eroilor Sanitari
Boulevard, Bucharest, Romania
*corresponding author: tpapacocea@hotmail.com
#Authors with equal contribution
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Abstract:
The purpose of this study was to assess whether the use of dexamethasone in patients with chronic subdural hematomas
(CSDH) could lead to avoidance of surgical treatment. Data in the literature showed benefits of dexamethasone in selected
patients, sometimes grouped in large cohorts, but studies comparing groups of patients who received or not this medication,
from the point of view of surgical therapy prevention, are missing. We analysed 38 patients with the diagnostic of chronic
subdural hematoma, separated in 2 groups on the basis of presence or absence of dexamethasone therapy. We found that
59.1% of patients who received dexamethasone didn’t need surgical intervention, while only 18.7% of patients who were not
treated with dexamethasone escaped surgery. In conclusion, the conservative treatment with dexamethasone can be a safe and
efficient therapeutic option for CSDH, which can be used with few risks even in elderly patients with important comorbidities,
when the surgical option would be hazardous. With few exceptions, CSDH should not be considered a
neurosurgical emergency, treatment with dexamethasone being usually attempted without significant risk for 48 - 72 hours.
Conservative therapy eliminates the complications related to surgery, some of which are severe. Essentially, dexamethasone
therapy involves shorter hospitalization, lower costs, rare severe complications and the possibility for outpatient treatment
and follow up. Dexamethasone medication should not be considered a substitute for surgery but an alternative in the majority
of cases.






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