Romanian Society of Pharmaceutical Sciences
 

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THE USEFULNESS OF DEXAMETHASONE IN THE TREATMENT OF CHRONIC SUBDURAL HEMATOMAS

TOMA PAPACOCEA 1#*, EMIL POPA 2#, TURLIUC DANA 3#, RALUCA PAPACOCEA 4

1.Department of Neurosurgery, “Sf. Pantelimon” Emergency Hospital, 340 Pantelimon Road, Bucharest, Romania
2.Department of Neurosurgery, “Dr. Carol Davila” Central Military Emergency University Hospital, 134 Calea Plevnei Street, Bucharest, Romania
3.Department of Neurosurgery, “N. Oblu” Hospital, “Gr. T. Popa” University of Medicine and Pharmacy, Iași, Romania
4.Department of Physiology, “Carol Davila” University of Medicine and Pharmacy, Faculty of Medicine, 8 Eroilor Sanitari Boulevard, Bucharest, Romania

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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 co-morbidities, 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.