Efficacité de la corticothérapie dans le traitement adjuvant des hématomes sous-duraux chroniques. Étude rétrospective sur 198 cas

Dran, G.; Berthier, F.; Fontaine, Denys; Rasenrarijao, D.; Paquis, Philippe

doi:10.1016/j.neuchi.2007.09.146

Cited by 45 publications

(18 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In another retrospective study including 496 patients, preoperative corticosteroid administration seemed to reduce the recurrence rate of CSDH after burr-hole craniostomy without increasing the incidence of complications and treatment-related deaths [21]. A retrospective study testing the efficacy of corticosteroids as adjuvant therapy to surgery (142 patients with adjuvant corticosteroids and 56 patients without adjuvant corticosteroids) showed a trend toward a survival benefit with medical treatment (risk of death three-fold less in the case of adjuvant corticosteroids ( p = 0.006)) [24]. Despite this data, there is a lack of published evidence concerning the efficacy of corticosteroids in reducing the rate of surgery.…”

Section: Discussionmentioning

confidence: 99%

Steroids in chronic subdural hematomas (SUCRE trial): study protocol for a randomized controlled trial

Henaux

Reste

Laviolle

et al. 2017

Trials

View full text Add to dashboard Cite

BackgroundChronic subdural hematoma (CSDH) is a common neurological pathology, especially in older patients. The actual “gold standard” of treatment is surgical evacuation, with various techniques used across neurosurgical teams. Over the years, there has been growing evidence that inflammatory processes play a major role in the pathogenesis of CSDH. In that context, the use of corticosteroids has been proposed alone or as an adjuvant treatment to surgery. However, this practice remains very empirical and there is a need for high-quality-of-evidence studies to clarify the role of corticosteroids in the management of CSDH.Methods/designWe propose a double-blind, randomized controlled trial comparing methylprednisolone versus placebo in the treatment of CSDH without clinical and/or radiological signs of severity. The treatment will be administered daily for a duration of 3 weeks, at a dose of 1 mg/kg. The primary endpoint will be the delay of occurrence of surgical treatment at 1 month following the introduction of the treatment. Secondary endpoints will include the rate of recourse to surgery, survival rate, quality of life and functional assessments, occurrence of systemic secondary effects and radiological assessment of the response to treatment. This multimodal assessment will be done at 1, 3 and 6 months. Two hundred and two patients (101 per arm) are expected to be included considering our primary hypotheses.DiscussionThis trial started in June 2016; its results may open interesting alternatives to surgery in the management of patients harboring a CSDH, and may provide insights into the natural history of this common pathology.Trial registrationClinicalTrials.gov, ID: NCT02650609. Registered on 4 January 2016.Graphical AbstractGraphical output of the OBF boundaries. Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-017-1990-8) contains supplementary material, which is available to authorized users.

show abstract

Section: Discussionmentioning

confidence: 99%

Steroids in chronic subdural hematomas (SUCRE trial): study protocol for a randomized controlled trial

Henaux

Reste

Laviolle

et al. 2017

Trials

View full text Add to dashboard Cite

show abstract

“…Several retrospective [21,27,30-36] and two prospective [25,28] studies about the use of cortisone in cSDH have been published. Two representative trials are discussed.…”

Section: Discussion Of Underlying Literaturementioning

confidence: 99%

“…The second study [21] was of 142 patients treated with methylprednisolon and surgery, and 56 patient who only received surgery. The cortisone therapy decreased the risk of death threefold.…”

Section: Discussion Of Underlying Literaturementioning

confidence: 99%

“…Frati [9] and Labadie [19,20] reported that due to the proof of proinflammatory and inflammatory cytogene that anti-inflammatory therapy may be beneficial. However, several national surveys show a controversial use of cortisone in treatment of cSDH: 38% of French neurosurgeons use adjuvant corticosteroid therapy after surgery [21]. For 13% of Canadian neurosurgeons cortisone plays a role in the treatment of cSDH [22], and 55% of surgeons in the UK and Ireland prescribe steroids in conservatively managed patients [23].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The efficacy of dexamethasone on reduction in the reoperation rate of chronic subdural hematoma – the DRESH study: straightforward study protocol for a randomized controlled trial

Emich

Richling

McCoy

et al. 2014

Trials

View full text Add to dashboard Cite

BackgroundChronic subdural hematoma (cSDH) is a common neurosurgical disease. It is often considered to be a rather benign entity. In spite of well established surgical procedures cSDH is complicated by a recurrence rate up to 30%. Since glucocorticoids have been used for treatment of cSDH in 1962 their role is still discussed controversially in lack of evident data. On the basis of the ascertained inflammation cycle in cSDH dexamethasone will be an ideal substance for a short lasting, concomitant treatment protocol.Objective: to test the efficacy of dexamethasone on reduction inthe reoperation rate of cSDH.Methods/DesignThe study is designed as a double-blind randomized placebo-controlled trial 820 patients who are operated for cSDH and from the age of 25 years are included after obtaining informed consent. They are randomized for administration of dexamethasone (16-16-12-12-8-4 mg/d) or placebo (maltodextrin) during the first 48 hours after surgery. The type I error is 5% and the type II error is 20%. The primary endpoint is the reoperation within 12 weeks postoperative.DiscussionThis study tests whether dexamethasone administered over 6 days is a safe and potent agent in relapse prevention for evacuated cSDH.Trial registrationEudraCT 201100354442

show abstract

“…CSH is consecutive to trauma in a large proportion with a frequency varying from 56% to 80% (10)(11)(12)(13)(14)(15)(16). Other risk factors include coagulopathies, therapeutic anticoagulation, antiplatelet agents, alcohol abuse, epilepsy, and intracranial hypotension (6,(17)(18)(19)(20)(21)(22)(23)(24)(25). CSH has been described to arise in patients who had presented an acute subdural hematoma or hygroma (26)(27)(28)(29)(30); but the latter is more related to the disease.…”

Section: Background and Importancementioning

confidence: 99%

Open Drainage in Chronic Subdural Hematomas: A Prospective Study of 189 Cases

Bakhti

Tighilt

Djennas

2016

IrJNS

View full text Add to dashboard Cite

Background & Importance: Chronic subdural hematoma (CSH) is one of the most frequent intracranial hemorrhages in adults. However, gold standard treatment of CSH is not yet defined. Since the 80's, closed drainage is a standard among techniques using drains because the open type has been incriminated in high rates of postoperative infections. However, closed drainage requires materiel which is sometimes not available or expensive in some countries. Open drainage was reintroduced in our department in the middle of the 90's because of economic crisis at this time. We have then conducted a prospective study to assess safety and efficacy of open drainage in treatment of CSH.Case Presentation: A prospective study of adult patients with CSH was conducted from January 2008 to December 2011. All patients have the same surgical procedure which included one burr-hole craniostomy, spontaneous evacuation and open drainage. The study focused on infectious complications, postoperative seizures, and recurrences. Results are compared with those of literature. In our study, 189 patients were operated with mean age of 69.2 years old. Of all, 163 patients were cured. Overall rate of complications was 15.34% with an infection rate of 1.58%, a postoperative seizure rate of 1.05% and a recurrence rate of 14.2%. Mortality rate was 5.8%. Results were in concordance with those of large series of literature. Conclusion:Data of the current study suggested that open drainage is a safe and efficient method in treatment of CSH. It is also a costefficient treatment that could be very interesting for middle-and low-income countries. Keywords AbstractBackground and Importance

show abstract

Efficacité de la corticothérapie dans le traitement adjuvant des hématomes sous-duraux chroniques. Étude rétrospective sur 198 cas

Cited by 45 publications

References 22 publications

Steroids in chronic subdural hematomas (SUCRE trial): study protocol for a randomized controlled trial

Steroids in chronic subdural hematomas (SUCRE trial): study protocol for a randomized controlled trial

The efficacy of dexamethasone on reduction in the reoperation rate of chronic subdural hematoma – the DRESH study: straightforward study protocol for a randomized controlled trial

Open Drainage in Chronic Subdural Hematomas: A Prospective Study of 189 Cases

Contact Info

Product

Resources

About