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Effects of Oral Streptokinase-Streptodornase on Remnant Chronic Subdural Hematomas
Min Park1, Jeong Mi Kim1, Hyo Joon Kim1
1Department of Neurosurgery, Presbyterian Medical Center, Jeonju, Korea.
Insights
Oral streptokinase-streptodornase (OSS) did not significantly reduce remnant chronic subdural hematoma (CSDH) volume or recurrence after drainage. Further use of OSS in CSDH patients is not supported by this study.
Area of Science:
- Neurosurgery
- Medical Research
Background:
- Chronic subdural hematoma (CSDH) can persist postoperatively.
- Outcomes of remnant CSDH after catheter removal are not well-understood.
Purpose of the Study:
- To evaluate the efficacy of oral streptokinase-streptodornase (OSS) in managing remnant CSDH.
- To assess OSS effects on hematoma volume and recurrence rates.
Main Methods:
- Retrospective analysis of 101 patients with traumatic CSDH and remnant hematoma post-drainage.
- Comparison of clinical outcomes, remnant CSDH volume, and recurrence rates between OSS-treated and non-treated groups.
- Computed tomography scans used for volume and recurrence assessment.
Main Results:
- No significant difference in remnant hematoma volume change between OSS-treated and non-treated groups (p=0.531).
- Reoperation rates were similar: 5.4% in the OSS group vs. 6.3% in the non-treated group (p=0.658).
Conclusions:
- OSS treatment did not demonstrate a significant reduction in remnant CSDH volume.
- OSS was not associated with a lower recurrence rate after burr-hole drainage.
- Current evidence does not support the use of OSS for remnant CSDH management.
Objective:
In most cases, the postoperative course of a chronic subdural hematoma (CSDH) is good, but CSDHs sometimes remain after the inserted catheter is removed, and the outcomes of such remnant hematomas are unclear. As oral streptokinase-streptodornase (OSS) has anti-inflammatory and hematologic effects, we assessed the effects of OSS on remnant CSDHs through a retrospective analysis of clinical data.
Methods:
This study included 101 patients with traumatic CSDH who had remnant CSDH after burr-hole trephination with the closed drainage system between October 2009 and December 2012. We assessed the clinical outcomes, remnant CSDH volume, and recurrence rate from computed tomography scans in order to evaluate the effects of OSS.
Results:
No significant differences were found in the changes in remnant hematoma volume between the OSS-treated and non-treated groups (p=0.531). The reoperation rate because of was 5.4% (2 patients) in the OSS-treated group and 6.3% (4 patients) in the non-treated group. The number of patients requiring reoperation did not differ between the groups (p=0.658).
Conclusion:
OSS treatment was not associated with a significant reduction in the remnant CSDH volume or recurrence rate after burr-hole drainage. Thus, there seems to be no basis for using OSS in CSDH patients.
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