Related Experiment Video
Updated: Mar 17, 2026
Intrastriatal Injection of Autologous Blood or Clostridial Collagenase as Murine Models of Intracerebral Hemorrhage
Published on: July 3, 2014
Effect of atorvastatin on resolution of chronic subdural hematoma: a prospective observational study [RETRACTED]
Hua Liu1,2, Zhongkun Liu3, Yong Liu1
1Department of Neurosurgery, The Affiliated Brain Hospital, Nanjing Medical University, Nanjing.
Insights
Atorvastatin significantly reduced the need for surgery in chronic subdural hematoma (CSDH) patients. Favorable patient characteristics, like female sex and lower dependency, predicted avoiding surgery when treated with atorvastatin.
Area of Science:
- Neurosurgery
- Pharmacology
Background:
- Chronic subdural hematoma (CSDH) is common in the elderly and often requires surgical drainage, which carries risks.
- Atorvastatin shows potential in treating CSDH due to its anti-inflammatory and proangiogenesis properties, potentially reducing the need for surgery.
Purpose of the Study:
- To investigate the efficacy of atorvastatin in treating CSDH.
- To identify patient characteristics associated with positive response to atorvastatin therapy for CSDH.
Main Methods:
- A prospective, placebo-controlled observational study involving 80 CSDH patients randomly assigned to atorvastatin or placebo.
- Follow-up for 12 months, collecting clinical data and comparing outcomes between groups.
- Logistic regression analysis to identify predictors of surgical intervention, including age, sex, Markwalder grade, ADL dependency, hemiparesis, and hematoma volume.
Main Results:
- Significantly fewer patients in the atorvastatin group required surgery compared to the placebo group (p = 0.001).
- The mean time to surgery was longer in the atorvastatin group (p = 0.018).
- Within the atorvastatin group, favorable Markwalder grades, lower ADL dependency, and smaller hematoma volumes predicted the need for surgery.
Conclusions:
- Atorvastatin administration effectively reduces the likelihood of surgical intervention for chronic subdural hematoma.
- Female sex, favorable admission Markwalder grades, and lower ADL dependency are independent predictors for avoiding surgery in CSDH patients treated with atorvastatin.
Abstract:
OBJECTIVE Chronic subdural hematoma (CSDH) is prevalent in the aged population and is commonly treated with bur hole drainage. This treatment, however, can lead to various surgical complications. Atorvastatin may cure CSDH via its antiinflammatory and proangiogenesis effects, but not all patients treated with this medication can avoid surgery. The authors' aim was to investigate the effect of atorvastatin and identify characteristics of patients with CSDH sensitive to atorvastatin therapy. METHODS A prospective, placebo-controlled observational study was conducted in 80 patients with evidence of CSDH. The patients were enrolled between February 2012 and August 2014 and were randomly assigned to either atorvastatin treatment (atorvastatin group) or placebo (control group). Patients were followed up for 12 months after initiation of treatment. Clinically relevant data were collected and compared between the 2 groups. The atorvastatin group was subdivided into patients who required surgery and those who did not, and characteristics of these subgroups were also compared. The relationship between atorvastatin treatment and need for surgery was investigated by means of multiple regression analysis using the following variables as predictors: age, sex, admission Markwalder grade, level of dependency in activities of daily living (ADL) as assessed with the modified Barthel Index, presence of hemiparesis, and hematoma volume. RESULTS The proportion of patients who required surgical intervention during the follow-up period was significantly lower in the atorvastatin group than in the control group (p = 0.001), and the mean time to surgery was longer in the atorvastatin group (p = 0.018). Within the atorvastatin group, there was a significant difference with respect to Markwalder grades, degree of dependency in ADL, percentage of patients with hemiparesis, and mean hematoma volume between the patients who required surgery during the follow-up period and those who did not (p = 0.002, p = 0.001, p = 0.001, and p = 0.012, respectively). The results of the logistic regression analysis showed that atorvastatin significantly reduced the probability of surgery and that female sex and favorable admission Markwalder grades and favorable dependency status with respect to ADL (independent, slightly dependent, or moderately dependent) were independent predictors of not requiring surgery. CONCLUSIONS Atorvastatin administration can promote the resolution of CSDH, especially for women with favorable Markwalder grades and favorable ADL dependency status at admission.
