Uso de dexametasona en pacientes con hematoma subdural crónico: una revisión sistemática.

Alcaraz-López, Daniela; Ayala-Obeso, Alondra; Reyes-Pérez, Narce D.

Background: Chronic subdural hematoma (CSCH) is an old collection of blood and its degradation products in the subdural space, the treatment of choice in symptomatic patients is craniotomy, although it brings complications. The search for alternative therapies has increased, highlighting glucocorticoids, especially dexamethasone (DXM). objective: To describe the efficiency, efficacy, and safety of the use of DXM in patients older than 18 years with CSCH in comparison with surgical drainage or placebo group. Method: Systematic review conducted according to PRISMA 2020 guidelines. Advanced searches were conducted in English and Spanish language, in the NEJM, PubMed and Embase databases through Cochrane Library using the descriptors and Boolean operators' "Dexamethasone" AND "Hematoma, Subdural, Chronic", and custom year range 2018-2023. results: 44 articles were found, of which, after discarding duplicates and applying the inclusion and exclusion criteria, only five articles were included. conclusion: The review shows a positive impact on the risk of recurrence with the use of DXM in patients with CSDH; however, no conclusive results were found since this impact was only demonstrated in four of the five publications included. Likewise, the use of DXM in patients with CSDH is associated with an increased risk of complications and mortality, and no significant difference was demonstrated in functional outcomes and days of hospitalization compared to those who received primary surgery or placebo.

MEDICAL information storage & retrieval systems; PATIENT safety; PLACEBOS; DESCRIPTIVE statistics; CHRONIC diseases; SYSTEMATIC reviews; MEDLINE; DRUG efficacy; MEDICAL drainage; MEDICAL databases; SUBDURAL hematoma; ONLINE information services; DISEASE relapse; DEXAMETHASONE; EVALUATION; DISEASE risk factors

Archivos de Neurociencias, 2024, Vol 29, Issue 3, p97

1028-5938

Academic Journal

10.24875/ANC.M24000006