Short Hydrocortisone Long Effect

ABSTRACTBackground: Chronic subdural hematoma (cSDH) is a common neurological condition, particularly among the elderly, often presenting asymptomatically. This study aims to evaluate the efficacy of hydrocortisone as a monotherapy in patients with cSDH.Methods: In our clinic, patients over 18 years of age with newly diagnosed symptomatic cSDH detected by brain computed tomography (CT) were evaluated according to the Markwalder Grading Scale, which measures neurological outcomes from 0 to 4. Treatment was started with oral 100 mg hydrocortisone as monotherapy. A single burr hole craniotomy (BHC) was performed on the cSDH in the surgery.Results: A total of 102 patients were included in the study, with 47 assigned to the hydrocortisone group and 55 to the surgery group. The mean patient age was 66.8 years, with 58% being male. In the surgical group, 94.5% of patients exhibited favorable outcomes postoperatively, with 6.5% requiring reoperation. In the hydrocortisone group, 80.9% demonstrated clinical improvement at three months, while 19.2% required surgical intervention. Adverse events were observed in 14.9% of the hydrocortisone group and 3.6% of the surgical group. The average hospital stay was significantly shorter in the hydrocortisone group (2.9 vs. 6.8 days, p < 0.05).Conclusion: Hydrocortisone monotherapy shows potential as a viable treatment for select cSDH patients, particularly those with mild to moderate symptoms. Further prospective studies are needed to validate its long-term efficacy and safety.