Impact of antithrombotic therapy on surgical treatment in patients with chronic subdural hematoma

Toshiyuki Amano, Satoshi Matsuo, Yuichiro Miyamatsu, Sojiro Yamashita, Akira Nakamizo

Research output: Contribution to journalArticlepeer-review

8 Citations (Scopus)

Abstract

Objective: The effects of antithrombotic therapy on chronic subdural hematoma (CSDH) are controversial. Herein, we investigated the association of antithrombotic therapy with surgical complications and outcomes in patients with CSDH. Methods: We retrospectively analyzed 323 consecutive patients with CSDH who underwent single burr-hole craniostomy. Results: One hundred and eight patients (33%) underwent preoperative antithrombotic therapy. Hemorrhagic and thromboembolic complications were detected in 6 and 8 patients, respectively, which peaked at 3 and 4.5 days after CSDH surgery, respectively. CSDH recurrence was detected in 62 cases, and reoperation was required in 16 cases. Discontinuance of antiplatelet therapy for >2 weeks was significantly associated with thromboembolic complications (43%; p = 0.005). Postoperative use of multiple antithrombotic agents was significantly associated with CSDH recurrence (40%; p = 0.03). Further, earlier recurrence within 2 weeks was significantly associated with the following reoperation (62%; p = 0.006). Conclusions: To reduce morbidity and minimize the risk of CSDH reoperation, the optimal timing for resumption of antithrombotic agents is approximately 3 days after CSDH surgery. Postoperative use of multiple antithrombotic agents can increase CSDH recurrence, while earlier recurrence may be a predictor for the following reoperation.

Original languageEnglish
Pages (from-to)55-60
Number of pages6
JournalJournal of Clinical Neuroscience
Volume74
DOIs
Publication statusPublished - Apr 2020
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Surgery
  • Neurology
  • Clinical Neurology
  • Physiology (medical)

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