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January 1975

Medical Treatment of Subdural Hematomas Challenged

Author Affiliations

Washington, DC

Arch Neurol. 1975;32(1):69. doi:10.1001/archneur.1975.00490430091025

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Nonsurgicalgical Treatment of Subdural Hematomas" is of considerable interest. The author is a noted neurologist and has made many important contributions to the field of neurology. Unfortunately, this article is not one of them.

The surgical treatment of chronic subdural hematomas by evacuation with burr holes and drains is a well established neurosurgical procedure. The morbidity and mortality is negligible. Even the most ill patient can be operated on under local anesthesia with minimal risk. The operation is technically simple, the evacuation immediate, and the results gratifying. Clips placed on the dura and arachnoid at the time of surgery enable follow-up by routine skull x-ray study.

In view of this, which no neurosurgeon or neurologist who has had experience with this disease can dispute, what is the rationale for the medical management of subdural hematomas? The use of steroids, osmotic agents, multiple angiography, and prolonged bed rest for results

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