title: Local application of corticosteroids combined with surgery for the treatment of chronic subdural hematoma.
abstract: OBJECTIVE
  Combination treatment consisting of surgery and pre-or post-operative corticosteroids for chronic subdural hematoma (CSH) tend to have better outcomes than surgery only. However, there are many complications after long-term use of corticosteroids. In this study, we evaluated the clinical outcomes of local application of corticosteroids combined with surgery for CSH.
  
  
  METHODS
  We retrospectively analysed the data of the patients undergoing surgery and local application of Methylprednisolone Sodium Succinate for Injection (MPSS) into the hematoma cavity. Neurological status was assessed by Markwalder's Grading Scale (MGS). Recurrence was defined as deteriorating neurological status with radiological evidence of reaccumulation.
  
  
  RESULTS
  A total of 26 patients were enrolled in this study. During the follow-up period, all patients made excellent neurological recovery. 24 (92.3%) patients' MGS was grade 0 at 12 months after the surgery. There was no mortality or recurrence. 5 patients (19.2%) suffered postoperative complications, of which 2 developed some subdural air collection, 2 had a partial seizure attack and 1 developed an acute epidural hemorrhage.
  
  
  CONCLUSIONS
  The results suggest that local application of MPSS combined with surgery is a safe and effective method in the management of CSH. It may reduce hematoma recurrence.
authors.affiliation: The First People's Hospital of Neijiang, Department of Neurosurgery, Neijiang, Sichuan, China.
authors.forename: Xiao-Ping
authors.initials: XP
authors.lastname: Xu
authors.forename: Cong
authors.initials: C
authors.lastname: Liu
authors.forename: Jian
authors.initials: J
authors.lastname: Liu
authors.forename: Yuan-Guang
authors.initials: YG
authors.lastname: Pang
authors.forename: Xu-Dong Lu
authors.initials: XD
authors.lastname: O
authors.forename: Jun
authors.initials: J
authors.lastname: Fu
authors.forename: Liang
authors.initials: L
authors.lastname: Zhou
authors.forename: Ying-Zhong
authors.initials: YZ
authors.lastname: Fan
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D020200:Hematoma, Subdural, Chronic / Q000188:drug therapy* / Q000601:surgery*; D006801:Humans; D008297:Male; D008776:Methylprednisolone Hemisuccinate / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D008875:Middle Aged; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D008776:Methylprednisolone Hemisuccinate