New medical therapy of chronic subdural hematoma with tranexiamic acid without operations

Keywords: subdural hematoma, medication, hemorrhage, outcome, trauma

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     Chronic subdural hematoma (CSDH) is a common disease for neurosurgeons.
     Usually, with opening a burr hole and drainage of a liquid hematoma, we can cure it. However, the recurrence of CSDH and subdural effusion after surgery always remain.
     We analyzed here the effect of tranexiamic acid as a primary therapy for CSDH. We reviewed 17 consecutive cases of CSDH (mean age: 78.9 years) medically treated in Satte General Hospital between 2007 and 2010.
     We did burr hole surgeries in the early 3 cases. In all cases, we gave tranexiamic acid (300 mg) every day. Each case was followed up with CT scans or MRI every 21 days. The volume of hematoma was calculated from CT or MRI, before and after the therapy.
     We followed up each cases for 61.7±37.8 days. Before the therapy, the mean volume of hematoma is 70.7±59.3 ml. After the therapy, the mean volume was 8.0±6.9 ml. There has not been any cases of recurrence.
     This is a retrospective study.
     CSDH can be treated with tranexiamic acid without an operation.
     Especially, in case of high risk for an operation, we should cure it by tranexiamic acid.


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