The Use of Adjuvant Dexamethasone in Chronic Subdural Hematoma After Surgery

The use of oral anticoagulants in elderly patients is a predisposing factor in developing a subdural hematoma (SDH). The surgical option is often the standard approach but can be accompanied by complications. In this study, we hypothesized that dexamethasone administration after surgery would positively affect subdural change and subdural size in the second week.

Within the scope of this prospective research, 66 individuals who underwent surgical intervention for chronic subdural hematoma (CSH) at the neurosurgery department either as an outpatient or under emergency circumstances have been enrolled in the study. During the examination, the patients were questioned about the traumatic incident, the localization of injury, and the utilization of anticoagulant and antiplatelet medications. The Glasgow Coma Scale (GCS) was administered to all patients to assess neurological deficits. Computed tomography (CT) was utilized to determine the characteristics of the hematoma.

A total of 66 patients, 22 (33.3%) using and 44 (66.6%) not using dexamethasone, were included in the study. Analysis of variance (ANOVA) indicated that a statistical difference was achieved in the second week after the operation (p<0.043). During the examination of subdural dimensions after the operation and in the second postoperative week, a difference was detected between the radiological membrane and subdural dimensions. A statistically significant correlation was found between anticoagulation and the type of hematoma (p<0.025).

Regarding the outcomes of this research, we can conclude that dexamethasone was not associated with any adverse events. Additionally, dexamethasone could leverage reoperation prevention for the elderly with various comorbidities.