Traitement des hématomes sous-duraux chroniques par les corticoïdes : à propos de deux observations

Decaux, Olivier; Cador, B.; Dufour, Thierry; Jégo, Patrick; Cazalets, C.; Laurat, E.; Grosbois, B.

doi:10.1016/s0248-8663(02)00676-8

Cited by 22 publications

(3 citation statements)

References 12 publications

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“…Conservative management is often reserved for asymptomatic patients without significant brain compression or midline shift (10). Such management includes frequent follow-up imaging, reversal and discontinuation of anticoagulation, and often the administration of corticosteroids (10,(26)(27)(28)(29)(30)(31)(32)(33)(34). Steroids are thought to inhibit the formation of the neomembrane and neovessels by suppressing both fibrinolysis and inflammation (35).…”

Section: Demographic Characteristics and Treatmentmentioning

confidence: 99%

Middle Meningeal Artery Embolization for Chronic Subdural Hematoma

et al. 2020

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Chronic subdural hematoma (cSDH) is a common disease process associated with significant morbidity that occurs most often in elderly patients. Asymptomatic patients are typically treated conservatively, with surgical intervention reserved for patients with symptomatic and/or large hematomas that cause brain compression. However, conservatively managed cSDH cases frequently progress, and surgical evacuation of cSDH is associated with high rates of complication and recurrence. Recently, successful treatment of cSDH via middle meningeal artery (MMA) embolization has been reported in small case series and case reports. This article reviews the existing literature on MMA embolization for cSDH and discusses the need for randomized control trials and/or large prospective studies to establish the efficacy of MMA embolization for this disease.

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Section: Demographic Characteristics and Treatmentmentioning

confidence: 99%

Middle Meningeal Artery Embolization for Chronic Subdural Hematoma

et al. 2020

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“…There were some case reports of positive results of CSDH with corticosteroids. [ 13 14 15 16 ] Out of all the drugs tried for CSDH, corticosteroids were the most common.…”

Section: Nonsurgical Medical Treatment Of Chronic Subdural Hematomamentioning

confidence: 99%

The role of medical treatment in chronic subdural hematoma

Thotakura

Marabathina

2018

Asian J Neurosurg

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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.

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“…However, the scientific literature on the subject is still very limited [21]. In fact, only case reports and preliminary nonrandomized or retrospective studies have suggested the efficacy of steroids alone or as adjuvant therapy to surgery [22–26]. …”

Section: Introductionmentioning

confidence: 99%

Steroids in chronic subdural hematomas (SUCRE trial): study protocol for a randomized controlled trial

Henaux

Reste

Laviolle

et al. 2017

Trials

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BackgroundChronic subdural hematoma (CSDH) is a common neurological pathology, especially in older patients. The actual “gold standard” of treatment is surgical evacuation, with various techniques used across neurosurgical teams. Over the years, there has been growing evidence that inflammatory processes play a major role in the pathogenesis of CSDH. In that context, the use of corticosteroids has been proposed alone or as an adjuvant treatment to surgery. However, this practice remains very empirical and there is a need for high-quality-of-evidence studies to clarify the role of corticosteroids in the management of CSDH.Methods/designWe propose a double-blind, randomized controlled trial comparing methylprednisolone versus placebo in the treatment of CSDH without clinical and/or radiological signs of severity. The treatment will be administered daily for a duration of 3 weeks, at a dose of 1 mg/kg. The primary endpoint will be the delay of occurrence of surgical treatment at 1 month following the introduction of the treatment. Secondary endpoints will include the rate of recourse to surgery, survival rate, quality of life and functional assessments, occurrence of systemic secondary effects and radiological assessment of the response to treatment. This multimodal assessment will be done at 1, 3 and 6 months. Two hundred and two patients (101 per arm) are expected to be included considering our primary hypotheses.DiscussionThis trial started in June 2016; its results may open interesting alternatives to surgery in the management of patients harboring a CSDH, and may provide insights into the natural history of this common pathology.Trial registrationClinicalTrials.gov, ID: NCT02650609. Registered on 4 January 2016.Graphical AbstractGraphical output of the OBF boundaries. Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-017-1990-8) contains supplementary material, which is available to authorized users.

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Traitement des hématomes sous-duraux chroniques par les corticoïdes : à propos de deux observations

Cited by 22 publications

References 12 publications

Middle Meningeal Artery Embolization for Chronic Subdural Hematoma

Middle Meningeal Artery Embolization for Chronic Subdural Hematoma

The role of medical treatment in chronic subdural hematoma

Steroids in chronic subdural hematomas (SUCRE trial): study protocol for a randomized controlled trial

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