Anticoagulants and antiplatelet agents and the risk of development and recurrence of chronic subdural haematomas

Lindvall, Peter; Koskinen, Lars-Owe D.

doi:10.1016/j.jocn.2009.01.001

Cited by 129 publications

(88 citation statements)

References 18 publications

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“…Old age, brain atrophy, poor health status at the time of admission, high bleeding tendency, accompanying kidney and liver diseases, chronic alcoholism, diabetes mellitus, epilepsy, dementia and intracranial hypotension due to cerebrospinal fluid shunt are reported to be relevant factors of CSDH re-currence (8,14,52). Especially anti-platelet agents and poor reexpansion of the brain have been suggested risk factors for recurrence of CSDH (52,55,56). As compatible with the literature, coagulopathy and brain atrophy are defined as two major risk factors for recurrence in the present study.…”

Section: Discussionmentioning

confidence: 99%

Treatment of chronic subdural hematoma: 5-year clinical experience

Oktay¹,

Olguner²,

Saraç³

et al. 2017

Eur J Ther

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Section: Discussionmentioning

confidence: 99%

Treatment of chronic subdural hematoma: 5-year clinical experience

Oktay¹,

Olguner²,

Saraç³

et al. 2017

Eur J Ther

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“…Other studies have also reported no relationship between the use of these medications and cSDH recurrence. 3,13 Although further studies may be needed to determine how to manage cSDH preoperatively, the use of fresh frozen plasma and vitamin K plasma in patients taking anticoagulants and the transfusion of platelets in patients taking antiplatelet medication may help in some cSDH cases. Regardless, if patients using antiplatelet or anticoagulant medications present with symptoms related to cSDH, surgical management of the cSDH can be performed immediately with subsequent resumption of these medications as necessary.…”

Section: Clinical Factors Associated With Outcomesmentioning

confidence: 99%

Acute intracranial bleeding and recurrence after bur hole craniostomy for chronic subdural hematoma

Pang

Lee

Kim

et al. 2015

JNS

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OBJECT There is inconsistency among the perioperative management strategies currently used for chronic subdural hematoma (cSDH). Moreover, postoperative complications such as acute intracranial bleeding and cSDH recurrence affect clinical outcome of cSDH surgery. This study evaluated the risk factors associated with acute intracranial bleeding and cSDH recurrence and identified an effective perioperative strategy for cSDH patients. METHODS A retrospective study of patients who underwent bur hole craniostomy for cSDH between 2008 and 2012 was performed. RESULTS A consecutive series of 303 cSDH patients (234 males and 69 females; mean age 67.17 years) was analyzed. Postoperative acute intracranial bleeding developed in 14 patients (4.57%) within a mean of 3.07 days and recurrence was observed in 37 patients (12.21%) within a mean of 31.69 days (range 10–104 days) after initial bur hole craniostomy. The comorbidities of hematological disease and prior shunt surgery were clinical factors associated with acute bleeding. There was a significant risk of recurrence in patients with diabetes mellitus, but recurrence did not affect the final neurological outcome (p = 0.776). Surgical details, including the number of operative bur holes, saline irrigation of the hematoma cavity, use of a drain, and type of postoperative ambulation, were not significantly associated with outcome. However, a large amount of drainage was associated with postoperative acute bleeding. CONCLUSIONS Bur hole craniostomy is an effective surgical procedure for initial and recurrent cSDH. Patients with hematological disease or a history of prior shunt surgery are at risk for postoperative acute bleeding; therefore, these patients should be carefully monitored to avoid overdrainage. Surgeons should consider informing patients with diabetes mellitus that this comorbidity is associated with an increased likelihood of recurrence.

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“…1,6,13,14 However, a recent meta-analysis failed to show a significant association between the use of aspirin (acetylsalicylic acid) and the occurrence of SDH. 5 Another frequent cause of referral to neurosurgical departments is normal-pressure hydrocephalus (NPH), which is recognized as a partly treatable cause of dementia.…”

mentioning

confidence: 99%

Aspirin is associated with an increased risk of subdural hematoma in normal-pressure hydrocephalus patients following shunt implantation

Birkeland¹,

Lauritsen

Poulsen

2015

JNS

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obJect In this paper the authors investigate whether shunt-treated patients with normal-pressure hydrocephalus receiving aspirin therapy are at increased risk of developing subdural hematoma (SDH). Methods Records from 80 consecutive patients who had undergone implantation of a cerebrospinal fluid shunt for the treatment of normal-pressure hydrocephalus were retrospectively reviewed. results Eleven cases of symptomatic SDH occurred, all among patients receiving aspirin or clopidogrel. The 5-year survival estimate was 0.3 (p < 0.0001) for users of aspirin and the hazard ratio was 12.8 (95% CI 3.1-53). coNclusioNs Patients on an aspirin therapy regimen have a markedly increased risk of SDH after a shunt has been implanted for the treatment of normal-pressure hydrocephalus. Users of clopidogrel may have an even greater risk.

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Anticoagulants and antiplatelet agents and the risk of development and recurrence of chronic subdural haematomas

Cited by 129 publications

References 18 publications

Treatment of chronic subdural hematoma: 5-year clinical experience

Treatment of chronic subdural hematoma: 5-year clinical experience

Acute intracranial bleeding and recurrence after bur hole craniostomy for chronic subdural hematoma

Aspirin is associated with an increased risk of subdural hematoma in normal-pressure hydrocephalus patients following shunt implantation

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