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Chronic Subdural Medical Management
David Roh1, Michael Reznik1, Jan Claassen1
1Department of Neurology, Columbia University Medical Center, 177 Fort Washington Avenue, Milstein Building 8GS-300, New York, NY 10032, USA.
Insights
Asymptomatic chronic subdural hematomas (cSDHs) are increasingly detected. This review discusses nonoperative medical management strategies for these common brain bleeds.
Area of Science:
- Neurology
- Neurosurgery
- Geriatric Medicine
Background:
- Chronic subdural hematomas (cSDHs) are becoming more prevalent.
- Increased detection is linked to aging populations and anticoagulant use.
- Some cSDHs exhibit spontaneous resolution.
Purpose of the Study:
- To review current and potential nonoperative medical management strategies for cSDH.
- To explore conservative approaches for asymptomatic or minimally symptomatic cSDH.
Main Methods:
- Literature review of nonoperative management of cSDH.
- Discussion of medical interventions and observation protocols.
Main Results:
- Asymptomatic cSDH detection is rising.
- Spontaneous resolution is a known characteristic of some cSDH.
- Medical management offers an alternative to surgery in select cases.
Conclusions:
- Nonoperative medical management is a viable option for select cSDH patients.
- Further research into optimal medical strategies is warranted.
- Conservative management may reduce healthcare burden and surgical risks.
Abstract:
Chronic subdural hematomas (cSDHs) that are asymptomatic or have minimal symptoms have become more prevalent, with an increased rate of detection with neuroimaging in the setting of an aging population and increasing use of anticoagulants. These cSDHs have been known to spontaneously resolve, and subsequent efforts have been made to study the role of nonoperative initial medical management strategies in these patients. Current and potential strategies for the medical management of cSDH are discussed.
