OBJECTIVE Chronic subdural hematoma (CSDH) is a condition that is frequently seen in the neurological and neurosurgical practice. Surgical treatment is overall preferred; however, conservative treatment is also an option. Both surgical and conservative treatment of CSDH vary across neurosurgeons. The aim of the present study was to evaluate different treatment strategies for CSDH among neurosurgeons in different countries. MATERIAL AND METHODS We designed a survey that was sent to neurosurgeons affiliated with the Congress of Neurological Surgeons.The questions were related to the conservative and surgical treatment methods of CSDH. Furthermore, we also included questions related to post-operative care. RESULTS 443 neurosurgeons completed the survey. 46.2 % of the respondents sometimes use dexamethasone as monotherapy. Overall, 26.2 % estimated dexamethasone to have a high efficacy on CSDH. A Glasgow Coma Score lower than 12 was considered to be the most important indication for surgery by 57.8 %. Double burr hole is the preferred surgical technique by 48.1 % of the respondents. One day after surgery, 69.3 % routinely orders a CT-scan. CONCLUSIONS The majority of the neurosurgeons worldwide remains reluctant in the use of conservative treatment methods in the management of CSDH. Further research is needed to assess the effectivity and side-effects of these conservative methods.

中文翻译：

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慢性硬膜下血肿保守和手术治疗的实践变化

目的 慢性硬膜下血肿 (CSDH) 是神经病学和神经外科实践中常见的一种疾病。总体上首选手术治疗；然而，保守治疗也是一种选择。CSDH 的手术和保守治疗因神经外科医生而异。本研究的目的是评估不同国家神经外科医生对 CSDH 的不同治疗策略。材料与方法 我们设计了一项调查，发送给隶属于神经外科医师大会的神经外科医师。问题涉及 CSDH 的保守和手术治疗方法。此外，我们还包括与术后护理相关的问题。结果 443 名神经外科医生完成了调查。46.2% 的受访者有时使用地塞米松作为单一疗法。总的来说，26。2 % 估计地塞米松对 CSDH 具有高效能。57.8% 的格拉斯哥昏迷评分低于 12 分被认为是最重要的手术指征。双钻孔是 48.1% 的受访者首选的手术技术。手术后一天，69.3% 的人定期进行 CT 扫描。结论 世界上大多数神经外科医生仍然不愿意在 CSDH 的管理中使用保守的治疗方法。需要进一步研究来评估这些保守方法的有效性和副作用。结论 世界范围内的大多数神经外科医生仍然不愿意在 CSDH 的管理中使用保守的治疗方法。需要进一步研究来评估这些保守方法的有效性和副作用。结论 世界上大多数神经外科医生仍然不愿意在 CSDH 的管理中使用保守的治疗方法。需要进一步研究来评估这些保守方法的有效性和副作用。