KISA ETKİLİ KORTİZON ,UZUN ETKİ

Yıl 2026, Cilt: 9 Sayı: 1, 175 - 179, 17.03.2026

Rıdvan Açıkalın , Mahmut Ferat

https://izlik.org/JA57FK26DX

Öz

Amaç: Kronik subdural hematom (cSDH), özellikle yaşlı insanlar arasında yaygın olan yaygın ve genelliklede semptom olmadan bir nörolojik hastalıktır. Çalışmamızdaki amaç cSDH olan hastalarda monoterapi olarak hidrokortizonun etkinliğini değerlendirmek.

Materyal ve Metod: Kliniğimizde 18 yaş üzerinde olan beyin bilgisayarlı tomografisinde (CT) yeni teşhis edilen semptomatik cSDH tespit edilen hastalar nörolojik sonucu 0'dan 4'e kadar ölçen Markwalder Grading Scale göre değerlendirildi. Monoterapi olarak oral 100 mg hidrokortizon ile tedaviye başlandı. Cerrrahide cSDH üzerine tek burr hole craniostomy yapıldı.

Sonuç: 102 hasta çalışmaya alındı. Bunlardan 47'si hidrokortizon grubuna ve 55'i cerrahi grubuna atandı. Hastaların 59'u erkek ve ortalama yaş 66.8 olarak saptandı. Cerrahi grupta, cerrahi sonrası 55 hastanın 52'inde olumlu bir sonuç gözlemlendi. Cerrahi grubundaki 55 hastanın 3'üne cSDH için tekrar cerrahi uygulandı. Hidrokortizon grubunda 3. ayda 47 hastanın 38'inde (%80.9) olumlu bir sonuç saptandı. Hidrokortizon grubunda 7 hastada, cerrahi grubunda 2 hastada özel ilgi uyandıran advers olaylar meydana geldi.

Tartışma cSDH hidrokortizon monoterapisi minimal yan etkiler ile klinik iyileşmede etkili olduğu görülmektedir..

Anahtar Kelimeler

HİDROKORTİZONE , KRONİK , subdural , kanama

Short Hydrocortisone Long Effect

https://izlik.org/JA57FK26DX

Öz

ABSTRACT
Background: 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.
Keywords: hydrocortisone, chronic subdural hematoma, burr hole craniostomy, corticosteroids

Anahtar Kelimeler

hydrocortisone , subdural , hematoma

Kaynakça

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