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Published on: April 18, 2019
Efficacy of Reinforced Restriction of Physical Activity on Chronic Subdural Hematoma: Prospective Pilot Study
Kun Hou1, Xiaobo Zhu1, Jinchuan Zhao1
1Department of Neurosurgery, The First Hospital of Jilin University, Changchun, Jilin, China.
Insights
Restricting physical activity may help resolve chronic subdural hematoma (CSDH). This pilot study found complete CSDH resolution in all patients after limiting physical activity, suggesting its role in CSDH progression.
Area of Science:
- Neurosurgery
- Neurology
Background:
- Chronic subdural hematoma (CSDH) presents challenges in surgical management due to recurrence, morbidity, and mortality.
- Conservative management is an emerging strategy for CSDH.
- Physical activity is hypothesized to influence CSDH progression.
Purpose of the Study:
- To evaluate the efficacy of restricted physical activity for managing asymptomatic or mild symptomatic CSDH.
Main Methods:
- A prospective pilot study was conducted.
- Twenty-six patients with CSDH were enrolled.
- The intervention involved reinforced restriction of physical activity.
Main Results:
- All 26 patients achieved complete CSDH resolution.
- Resolution occurred within 32 to 182 days (mean 73.1 days) of activity restriction.
- No recurrence was observed during follow-up.
Conclusions:
- Physical activity may play a role in CSDH progression.
- Further randomized controlled studies are needed for stable CSDH patients without intracranial hypertension.
Background:
Chronic subdural hematoma (CSDH) is a common entity in neurosurgical practice. However, as a result of the high rate in recurrence, morbidity, and mortality for surgical management, conservative management of CSDH is emerging as a new treatment strategy. Head trauma is a known risk factor of CSDH and plays as an initiator in the genesis of CSDH. We hypothesized that physical activity might also play an important role in the progression of an asymptomatic CSDH.
Methods:
A prospective pilot study aiming to evaluate the efficacy of reinforced restriction of physical activity for the management of asymptomatic or mild symptomatic CSDH was conducted. Twenty-six patients were enrolled in this study.
Results:
All 26 patients experienced complete resolution of the CSDH ranging from 32 to 182 days (73.1 ± 19.6 days) since the initiation of reinforced restriction of physical activity. Ages ranged from 43 to 84 years old (64.4 ± 9.6 years). No patient experienced recurrence of CSDH during the follow-up.
Conclusions:
According to our study, physical activity might play a role in the progression of CSDH. Further prospective randomized controlled study is warranted in stable patients without evident intracranial hypertension and impending cerebral herniation.
