Expert consensus on drug treatment of chronic subdural hematoma

• 作者: Zhang Jianning Chinese Society of Neurosurgery Chinese Medical Association Chinese Neurosurgical Critical Care Specialist Council Collaborational Group of Chinese Neurosurgical Translational and Evidence-based Medicine
• 来源期刊: 中华神经外科杂志（英文）
• 年，卷（期）: 2022,（1）
• 所属期刊栏目: Review
• 页码范围: 51-59
• 页数: 9页
• 语种: 中文
• DOI: 10.1186/s41016-021-00263-z

摘要

Chronic subdural hematoma (CSDH) is a chronic space-occupying lesion formed by blood accumulation between arachnoid and dura mater, which is usually formed in the third week after traumatic brain injury. Surgical treatment is usually the first choice for patients with CSDH having a significant space-occupying effect. Most of the patients showed good results of surgical treatment, but still some patients had a postoperative recurrence (the recurrence rate was up to 33%). Because CSDH is often seen in the elderly, patients are weak and have many basic diseases. The risk of surgical treatment is high; serious complications and even death (the death rate is up to 32%) can often occur. The overall good prognosis rate of patients aged more than 90 years is 24%. The drug treatment can provide a safe and effective treatment for elderly patients who are weak, intolerable to surgery, or failed in surgery. Low-dose and long-term use of atorvastatin (20mg/d) is suggested for continuous treatment for at least 8 weeks, while low-dose and short-term use of dexamethasone can improve the therapeutic effect of atorvastatin on CSDH. Patients should undergo CT or MRI scanning at least one time within 2 weeks after the start of drug treatment.