The role of steroids in prevention of early recurrence following surgical evacuation of chronic subdural hematoma

Abstract Background Surgical intervention is the first line treatment for most patients with chronic subdural hematoma, however, there is a significant recurrence rate following surgical evacuation. Postoperative steroids administration has proposed to decrease the rate of recurrence. This study aimed to evaluate the efficacy of postoperative steroids in decreasing the recurrence rate and the need for reoperation in patients operated upon for evacuation of chronic subdural hematoma. This prospective nonrandomized controlled study included 40 patients with chronic subdural hematoma operated upon by evacuation through burr holes. The patients were divided into 2 groups; one group included patients who received a 2 week regimen of dexamethasone postoperatively, while the other group included patients who did not receive postoperative dexamethasone. The recurrence rate, the need for reoperation, the clinical outcome and the complications related to steroids intake were assessed. Results The recurrence rate for all patients was 5%, and the difference between both groups was not statistically significant ( p value = 1). Both patients with recurrence were managed conservatively with no need for reoperation. The clinical outcome was similar between both groups and there were no steroid-related complications detected in patients who received dexamethasone for 2 postoperative weeks. Conclusion Postoperative administration of steroids for 2 weeks following surgical evacuation of chronic subdural hematoma did not result in decreasing the rate of recurrence following surgery, nor the rate of reoperation. There were no complications related to steroid administration in patients who received 2 weeks regimen of steroids postoperatively.