Medical management of chronic subdural hematoma with low-dose hydrocortisone: a case series

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dc.authorscopusidAbuzer Güngör / 54895233300
dc.authorwosidAbuzer Güngör / F-4189-2019
dc.contributor.authorGürses, Muhammet Enes
dc.contributor.authorÜlgen, Meriç
dc.contributor.authorGökalp, Elif
dc.contributor.authorGecici, Neslihan Nisa
dc.contributor.authorGüngör, Abuzer
dc.contributor.authorTüre, Hatice
dc.contributor.authorTüre, Uğur
dc.date.accessioned2025-04-18T10:29:48Z
dc.date.available2025-04-18T10:29:48Z
dc.date.issued2024
dc.departmentİstinye Üniversitesi, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü
dc.description.abstractChronic subdural hematomas (cSDH) are often managed with a burr-hole craniostomy and drainage, but surgery is associated with elevated mortality, morbidity, and recurrence. Despite reports of steroid use for such patients, its efficacy and feasibility are still debated. We present our patient series treated with low-dose hydrocortisone. We retrospectively reviewed data from patients treated with hydrocortisone between 2017 and 2023. Demographics, clinical and radiological data were collected. Of 27 patients identified, nine required a burr-hole craniotomy for an average volume of 120.23 cm3, average midline shift of 9 mm, and neurological deficits. Eighteen met the criteria for inclusion. The mean age was 78.5 years; 13 were male. None had severe symptoms requiring urgent intervention. Except for one with a Karnofsky Performance Scale score of 70, all could maintain normal activity before treatment. The mean baseline volume was 52.6 cm3. Midline shift, present in six, averaged 6.8 mm. Patients underwent treatment for an average of 5.15 months. Nine had complete resolution within 3 months, while nine required longer treatment, including one who needed 9 months for a re-bleed after a fall. Paired t-tests indicated significant reductions in hematoma volumes at the second week (p = 0.01), first month (p < 0.0001), and third month (p < 0.0001) of treatment. No complications occurred and the post-treatment Karnofsky scores ranged from 90 to 100. Treatment for cSDH should be tailored to the patient. Low-dose hydrocortisone is safe and effective in asymptomatic patients, those with mild to moderate symptoms, and those who are either unsuitable for or decline surgical intervention. © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2024.
dc.identifier.citationGurses, M. E., Ulgen, M., Gökalp, E., Gecici, N. N., Gungor, A., Türe, H., & Türe, U. (2024). Medical management of chronic subdural hematoma with low-dose hydrocortisone: a case series. Neurosurgical review, 47(1), 509.
dc.identifier.doi10.1007/s10143-024-02763-9
dc.identifier.issn03445607
dc.identifier.issue1
dc.identifier.scopus2-s2.0-85202880296
dc.identifier.scopusqualityQ1
dc.identifier.urihttp://dx.doi.org/10.1007/s10143-024-02763-9
dc.identifier.urihttps://hdl.handle.net/20.500.12713/7090
dc.identifier.volume47
dc.identifier.wosWOS:001303657200006
dc.identifier.wosqualityQ1
dc.indekslendigikaynakScopus
dc.indekslendigikaynakWeb of Science
dc.institutionauthorGüngör, Abuzer
dc.institutionauthoridAbuzer Güngör / 0000-0002-2792-7610
dc.language.isoen
dc.publisherSpringer Science and Business Media Deutschland GmbH
dc.relation.ispartofNeurosurgical Review
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.subjectChronic
dc.subjectGlucocorticoids
dc.subjectHematoma
dc.subjectHydrocortisone
dc.subjectSubdural
dc.titleMedical management of chronic subdural hematoma with low-dose hydrocortisone: a case series

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