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Surgical and Conservative Approaches have Comparable Outcomes in patients with acute subdural hematoma: JAMA

Written By : Dr. Shravani Dali |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2025-10-08T21:00:33+05:30  |  Updated On 9 Oct 2025 2:03 PM IST
Surgical and Conservative Approaches have Comparable Outcomes in patients with acute subdural hematoma: JAMA
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A recent study published in JAMA Network Open examined the outcomes of patients with acute subdural hematoma (ASDH) treated at centers with differing management strategies, comparing those that favor early surgical intervention with those that typically pursue conservative approaches. The authors reported that outcomes in terms of survival and neurological function were broadly comparable between the two treatment pathways.

This suggests that patient prognosis may not be determined solely by whether surgical or conservative care is pursued, but also by other clinical and contextual factors such as patient age, comorbidities, injury severity, and access to supportive care.

The study emphasized that acute subdural hematoma is a common and serious form of traumatic brain injury, often requiring complex decision-making in emergency care settings. Traditionally, surgical evacuation has been considered the gold standard for cases with significant hematoma volume or neurological deterioration.

However, the findings indicate that in certain patients, especially those who may be poor surgical candidates or present with less severe radiological and clinical profiles, conservative management can achieve outcomes comparable to those seen with early surgery. This raises important considerations for tailoring treatment plans to individual patient needs rather than adopting a universal approach.

According to the authors, these results support a more nuanced view of ASDH management and highlight the importance of multidisciplinary decision-making. Rather than adhering strictly to a single institutional philosophy of aggressive surgery or conservative care, clinicians should weigh the risks and benefits of both strategies based on patient-specific factors.

The findings also point to the potential value of standardized clinical pathways and improved risk stratification tools to guide treatment decisions. Ultimately, the study reinforces that both surgical and conservative management approaches can be viable, and optimizing outcomes depends on careful case selection and high-quality supportive care.

Reference:
Lingsma HF, Gravesteijn BY, Maas AIR, et al. Association of Center Preference for Surgery vs Conservative Treatment With Outcomes in Patients With Acute Subdural Hematoma. JAMA Network Open. 2025;8(9):e2339598. doi:10.1001/jamanetworkopen.2025.39598
Acute subdural hematomasurgical managementconservative managementtraumatic brain injuryoutcomesLingsma HFJAMA Network Open
Source : JAMA
Dr. Shravani Dali
Dr. Shravani Dali

    Dr. Shravani Dali has completed her BDS from Pravara institute of medical sciences, loni. Following which she extensively worked in the healthcare sector for 2+ years. She has been actively involved in writing blogs in field of health and wellness. Currently she is pursuing her Masters of public health-health administration from Tata institute of social sciences. She can be contacted at editorial@medicaldialogues.in.

    Dr. Kamal Kant Kohli
    Dr. Kamal Kant Kohli

    Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751

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