Atorvastatin combined with or without dexamethasone for the treatment of
chronic subdural hematoma in super-aged patients
Abstract
Aim:Chronic subdural hematoma (CSDH) is common in aged people, and
minimally invasive surgical interventions such as burr-hole-drainage and
twist-drill craniostomy are the first-line therapeutic options for this
condition. However, the mortality rate among super-aged patients (over
90 years of age) with CSDH is as high as 38.4% after these surgical
procedures. Atorvastatin alone or in combination with dexamethasone has
been proven to be effective in eliminating CSDH. In the current study,
the researchers evaluated the therapeutic efficacy of atorvastatin with
or without dexamethasone on the CSDH patients over 90 years.
Methods:The study attempted to treat 12 super-aged patients with
primary or post-operative relapsed CSDH by using atorvastatin alone or
in combination with dexamethasone. The changes in hematoma volume
measured with computed tomography (CT) or magnetic resonance imaging
(MRI) and the patients’ neurological improvement were monitored by
activities of daily living (ADL) and modified Rankin scale (MRS) scores.
Results:Treatment with atorvastatin or atorvastatin combined with
low-dose dexamethasone had beneficial effects on hematoma elimination
and/or symptom remission within 6 to 24 weeks in 12 super-aged patients.
All of them showed complete recovery after 1~4 years of
follow-up. Conclusion:The findings in this study indicate that
atorvastatin with or without dexamethasone is safe and effective for the
treatment for CSDH in super-aged patients.