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Double Direct Injection of Blood into the Cisterna Magna as a Model of Subarachnoid Hemorrhage
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Recent changes in risk factors of chronic subdural hematoma

Yang-Won Sim1, Kyung-Soo Min, Mou-Seop Lee

  • 1Department of Neurosurgery, Chungbuk National University College of Medicine, Cheongju, Korea.

Journal of Korean Neurosurgical Society
|November 2, 2012
PubMed

Insights

Anticoagulants and antiplatelet agents are increasingly significant risk factors for chronic subdural hematoma (CSDH). Careful prescription of these medications is advised due to their growing importance in CSDH development.

Area of Science:

  • Neurosurgery
  • Geriatrics
  • Pharmacology

Background:

  • Chronic subdural hematoma (CSDH) is a common neurosurgical condition.
  • Medications causing coagulopathies, like anticoagulants (ACs) and antiplatelet agents (APs), are known CSDH risk factors.
  • Increasing use of ACs/APs, particularly in the elderly, necessitates re-evaluation of CSDH risk factors.

Purpose of the Study:

  • To investigate the changing trends of risk factors for chronic subdural hematoma (CSDH).
  • To analyze the specific impact of anticoagulants (ACs) and antiplatelet agents (APs) on CSDH development over time.

Main Methods:

  • Retrospective review of 290 CSDH patients undergoing surgery between 1996 and 2010.
  • Classification of patients into three groups based on presentation period: 1996-2000, 2001-2005, and 2006-2010.
  • Comparative analysis of independent risk factors, including ACs/APs use, across the three time periods.

Main Results:

  • The proportion of CSDH patients using ACs/APs significantly increased over time (4.2% to 15.7%).
  • In the recent period (2006-2010), ACs/APs-related CSDH cases showed a lower association with trauma or alcohol compared to non-medication groups.
  • The number of CSDH patients increased across the study periods, with the recent group having the highest proportion (41.7%).

Conclusions:

  • Anticoagulants and antiplatelet agents have emerged as increasingly important risk factors for chronic subdural hematoma.
  • The association between ACs/APs and CSDH is becoming more prominent, with a reduced role for traditional risk factors like trauma and alcohol in medication-associated cases.
  • Healthcare providers should carefully consider the risk-benefit profile when prescribing ACs/APs due to their growing contribution to CSDH.
Abstract

Keywords:
AnticoagulantsAntiplatelet agentsChronic subdural hematomaRisk factors

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