Conservative therapy of chronic subdural hematomas

Abstract Between 1975 and 1984, subdural hematoma was diagnosed in 66 patients at the Department of Neurology, University Hospital, Zurich. In this report we evaluate the therapeutic results retrospectively. In 13 patients treatment was surgical, while 53 patients were treated medically, i.e. with bedrest and corticosteroids. Three surgery patients developed a recurrence which was then also treated medically. Of this total number of 56 patients in the medically treated group, 8 had to undergo surgery later and two patients died. Soporose patients with distinct focal symptoms and comatose patients with incipient herniation received immediate surgical treatment. Of the 46 medically treated patients, 83% were symptom-free and 17% showed residual symptoms. Comparing these results with those of surgical treatment in the literature, conservative treatment can be recommended if strict guidelines are observed.