Trial of Dexamethasone for Chronic Subdural Hematoma

Publication: New England Journal of Medicine

Peter J. Hutchinson, Ellie Edlmann, Diederik Bulters, Ardalan Zolnourian, Patrick Holton, Nigel Suttner,  Kevin Agyemang, Simon Thomson, Ian A. Anderson, Yahia Z. Al-Tamimi, Duncan Henderson, Peter C. Whitfield, Monica Gherle, Paul M. Brennan, Annabel Allison,  Eric P. Thelin, Silvia Tarantino, Beatrice Pantaleo, Karen Caldwell, Carol Davis-Wilkie, Harry Mee, Elizabeth A. Warburton, Garry Barton, Aswin Chari, Hani J. Marcus, Andrew T. King, Antonio Belli, Phyo K. Myint, Ian Wilkinson, Thomas Santarius, Carole Turner,  Simon Bond, Angelos G. Kolias,

16 December 2020


Summary:

Chronic subdural haematoma -the build-up of ‘old’ blood in the space between the brain and the skull, usually as a result of minor head injury – is one of the most common neurological disorders and mainly affects older people.

A commonly used steroid, dexamethasone, has been used alongside surgery or instead of it since the 1970s. However, consensus has been lacking regarding the use of dexamethasone, especially since no high-quality studies confirming its effectiveness had been conducted until now.

In a randomised trial, patients received a two-week tapering course of dexamethasone and were compared with 373 patients randomised to an identical matching placebo. Results showed patients who received dexamethasone had a lower chance of favourable recovery at six months compared to patients who received placebo. Read the full press release. 

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