Treatment of Chronic Subdural Hematoma by Corticosteroids

Treatment of Chronic Subdural Hematoma by Corticosteroids

Chronic subdural hematomas are a frequent neurosurgical pathology in the elderly. Gold standard is surgical evacuation of these hematomas. Physiopathology of chronic subdural hematoma involves numerous inflammatory processes which could be inhibited by steroids.

The primary objective is to evaluate the efficacy of corticosteroids treatment in patients with Chronic subdural hematomas without clinical or radiological signs of severity.

Secondary objectives are to assess the effect of methylprednisolone on:

• quality of life evolution,
• morbidity and mortality,
• radiological evolution of the lesions.

Inclusion Criteria:

• Age 18 years old,
• With chronic or subacute, uni or bilateral subdural hematoma,
• Confirmed by cerebral scan without contrast enhancement,
• Without clinical and radiological signs of severity,
• Written informed consent from patients or their next of kin according to the patients cognitive status.

Exclusion Criteria:

• Diabetics patients,
• Contraindication for methylprednisolone,
• Previous surgery for chronic subdural hematoma during the past 6 months,
• Pre-existing severe dementia related to other etiology than the Chronic subdural hematomas,
• Existing neurological pathology that can be associated with dementia,
• Patients treated with corticosteroids,
• Protected person (adults legally protected (under judicial protection, guardianship or supervision), person deprived of their liberty, pregnant woman, lactating woman and minor),
• Participating in other concomitant research.