Nonsurgical Treatment of Subdural Hematomas

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Abstract
Between 1958 and 1973, one hundred patients with subdural hematoma were successfully treated without surgery. This was achieved either with bed rest, corticosteroids, mannitol, or a combination. The initial diagnosis and subsequent improvement were confirmed by cerebral angiography, but clinical observations were more important in deciding the selection of therapy. Similar medical treatment was initiated in 22 others who later were operated on because of failure to respond. Medical treatment was not attempted in severely ill or comatose patients. Of 185 patients with subdural hematoma in the Mount Sinai Hospital series, 75 recovered without surgery. After the introduction of corticosteroid therapy in 1968, there was a higher incidence of successful treatment by medical means. Follow-up examinations revealed that recovery was excellent and has been maintained.