The Relation between Recurrence and Antiplatelet or Anticoagulant Agents on Chronic Subdural Hemorrhage

Hyun Min Choi; Tae Wan Kim; Kwan Ho Park; Moon Pyo Chi; Jae O Kim; Jung Chul Kim

doi:10.13004/jknts.2009.5.2.53

Journal List > J Korean Neurotraumatol Soc > v.5(2) > 1084049

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Choi, Kim, Park, Chi, Kim, and Kim: The Relation between Recurrence and Antiplatelet or Anticoagulant Agents on Chronic Subdural Hemorrhage

Clinical Article

Journal of Korean Neurotraumatology Society 2009; 5(2): 53-56.

Published online: 31 December 2009

DOI: https://doi.org/10.13004/jknts.2009.5.2.53

The Relation between Recurrence and Antiplatelet or Anticoagulant Agents on Chronic Subdural Hemorrhage

Hyun Min Choi, MD, Tae Wan Kim, MD, Kwan Ho Park, MD, Moon Pyo Chi, MD, Jae O Kim, MD, Jung Chul Kim, MD

Department of Neurosurgery, Seoul Veterans Hospital, Seoul, Korea.

Address for correspondence: Tae Wan Kim, MD. Department of Neurosurgery, Seoul Veterans Hospital, 27 Iljasan-gil, Gangdong-gu, Seoul 134-791, Korea. Tel: +82-2-2225-1363, Fax: +82-2-2225-1366, colloseum@freechal.com

Received 28 April 2009 Revised 13 July 2009 Accepted 14 September 2009

Abstract

Objective

The purpose of this study was to examine the corelation of the recurrence rate and the use of antiplatelet agent or anticoagulant agent on chronic subdural hematoma patient group, and to find the appropriate time that reuse the agents.

Methods

Between January 2007 and December 2008, 37 patients has undergone burr hole trephination for chronic subdural hematoma. Among them, 8 patients had been used antiplatelet or anticoagulant agent (agent using group). The other patients were agent non-using group. We reviewed medical and laboratory records retrospectively.

Results

Preoperative laboratory finding including prothrombin time (PT), activated partial thromboplastin time (aPTT), international normalized ratio (INR), bleeding time (BT) were all within normal range on agent using group. Follow up laboratory findings were also all within normal range. The recurrence rate on agent using group was not superior to agent non-using group (12.5% : 13.8%). The patients with heart problem were took medication again after drainage catheter removal (postoperative second or third day). The prescribed medicines were restarted to old cerebral infarction patients on postoperative seventh day.

Conclusion

The use of antiplatelet or anticoagulant agents are not influenced recurrence rate on chronic subdural hematoma operation if the patients have no bleeding tendency before operation. Re-administration of agents may be possible within postoperative seventh day.

Keywords: Chronic subdural hemorrhage, Antiplatelet agent, Anticoagulant agent, Recurrence

Figures and Tables

TABLE 1

Characteristics of the patients use antiplatelet or anticoagulant agents

No: number, MI: myocardial infarction

TABLE 2

Preoperative laboratory findings of the patients use antiplatelet or anticoagulant agents

No: number, PT: prothrombin time (10-12.7 sec, 77.0-124.6%), aPTT: activated partial thromboplastin time (26.9-40.8 sec), INR: international normalized ratio (0.89-1.11), BT: bleeding time (1-4 min), s ec: second, min: minute

References

1. European Atrial Fibrillation Trial Study Group. Secondary prevention in non-rheumatic atrial fibrillation and transient ischaemic attack or minor trauma. Lancet. 1993; 342:1255–1262.

2. Gallagher D. Current management of atrial fibrillation. Med Today. 2004; 5:41–51.

3. Gelabert-Gonzalez M, Iglesias-Pais M, Garcia-Allut A, Martinez-Rumbo R. Chronic subdural haematoma: surgical treatment and outcome in 1000 cases. Clin Neurol Neurosurg. 2005; 107:223–229.

4. Gonugunta V, Buxton N. Warfarin and chronic subdural haematomas. Br J Neurosurg. 2001; 15:514–517.

5. Kiymaz N, Yilmaz N, Mumcu C. Controversies in chronic subdural hematoma: continuous drainage versus one-time drainage. Med Sci Monit. 2007; 13:CR240–CR243.

6. Mellergård P, Wisten O. Operations and re-operations for chronic subdural haematomas during a 25-year period in a well defined population. Acta Neurochir (Wien). 1996; 138:708–713.

7. Nakaguchi H, Tanishima T, Yoshimasu N. Factors in the natural history of chronic subdural hematomas that influence their postoperative recurrence. J Neurosurg. 2001; 95:256–262.

8. Nakajima H, Yasui T, Nishikawa M, Kishi H, Kan M. The role of postoperative patient posture in the recurrence of chronic subdural hematoma: a prospective randomized trial. Surg Neurol. 2002; 58:385–387.

9. O'Brien DF, Basu S, O'Donnell JR, Roberts GA, Phillips J. The impact of aspirin therapy and anticoagulation on the prevalence of spontaneous subdural hematoma. Ir Med J. 2000; 93:244–246.

10. Okada Y, Akai T, Okamoto K, Iida T, Takada H, Iizuka H. A comparative study of the treatment of chronic subdural hematoma-burr hole drainage versus burr hole irrigation. Surg Neurol. 2002; 57:405–409.

11. Reymond MA, Marbet G, Radü EW, Gratzl O. Aspirin as a risk factor for hemorrhage in patients with head injuries. Neurosurg Rev. 1992; 15:21–25.

12. Rust T, Kiemer N, Erasmus A. Chronic subdural haematomas and anticoagulation or anti-thrombotic therapy. J Clin Neurosci. 2006; 13:823–827.

13. Tokmak M, Iplikcioglu AC, Bek S, Gökduman CA, Erdal M. The role of exudation in chronic subdural hematomas. J Neurosurg. 2007; 107:290–295.

14. Torihashi K, Saamasa N, Yoshida K, Narumi O, Chin M, Yamagata S. Independent predictors for recurrence of chronic subdural hematoma: a review of 343 consecutive surgical cases. Neurosurgery. 2008; 63:1125–1129.

15. Yamamoto H, Hirashima Y, Hamada H, Hayashi N, Origasa H, Endo S. Independent predictors of recurrence of chronic subdural hematoma: results of multivariate analysis performed using a logistic regression model. J Neurosurg. 2003; 98:1217–1221.

16. Zingale A, Chibbaro S, Florio A, Distefano G, Porcaro S. Management of chronic subdural hematoma in patients treated with anticoagulation. J Neurosurg Sci. 1999; 43:277–284.

TOOLS

Similar articles