J Korean Neurosurg Soc.  2012 Sep;52(3):234-239.

Recent Changes in Risk Factors of Chronic Subdural Hematoma

Affiliations
  • 1Department of Neurosurgery, Chungbuk National University College of Medicine, Cheongju, Korea. ksm@chungbuk.ac.kr

Abstract


OBJECTIVE
Chronic subdural hematoma (CSDH) is a typical disease that is encountered frequently in neurosurgical practice. The medications which could cause coagulopathies were known as one of the risk factors of CSDH, such as anticoagulants (ACs) and antiplatelet agents (APs). Recently, the number of patients who are treated with ACs/APs is increasing, especially in the elderly population. With widespread use of these drugs, there is a need to study the changes in risk factors of CSDH patients.
METHODS
We retrospectively reviewed 290 CSDH patients who underwent surgery at our institute between 1996 and 2010. We classified them into three groups according to the time of presentation (Group A : the remote period group, 1996-2000, Group B : the past period group, 2001-2005, and Group C : the recent period group, 2006-2010). Also, we performed the comparative analysis of independent risk factors between three groups.
RESULTS
Among the 290 patients, Group A included 71 patients (24.5%), Group B included 98 patients (33.8%) and Group C included 121 patients (41.7%). Three patients (4.2%) in Group A had a history of receiving ACs/APs, 8 patients (8.2%) in Group B, and 19 patients (15.7%) in Group C. Other factors such as head trauma, alcoholism, epilepsy, previous neurosurgery and underlying disease having bleeding tendency were also evaluated. In ACs/APs related cause of CSDH in Group C, significantly less proportion of the patients are associated with trauma or alcohol compared to the non-medication group.
CONCLUSION
In this study, the authors concluded that ACs/APs have more importance as a risk factor of CSDH in the recent period compared to the past. Therefore, doctors should prescribe these medications carefully balancing the potential risk and benefit.

Keyword

Chronic subdural hematoma; Anticoagulants; Antiplatelet agents; Risk factors

MeSH Terms

Aged
Alcoholism
Anticoagulants
Craniocerebral Trauma
Epilepsy
Hematoma, Subdural, Chronic
Hemorrhage
Humans
Neurosurgery
Platelet Aggregation Inhibitors
Retrospective Studies
Risk Factors
Anticoagulants
Platelet Aggregation Inhibitors
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