Management of Chronic Subdural Hematoma in Patients with Intractable Thrombocytopenia

Currently, the platelet count threshold for platelet transfusion, that is commonly used prior to surgical evacuation of chronic subdural hematoma (CSDH), is 100,000 per microliter. This study was done to show the outcome of the surgical evacuation of CSDH in patients with intractable thrombocytopenia (platelet count which did not reach 100,000 per microliter after platelet transfusions).

This study retrospectively reviewed the data of patients who were admitted to our university hospitals with symptomatic CSDH and intractable thrombocytopenia from January 2007 to January 2016.

Forty-one patients were included in this study. There was no incidence of intraoperative or postoperative acute bleeding in any patient.

Evacuation of CSDH in thrombocytopenic patients, without reaching a platelet count of 100,000 per microliter, is an option. Further randomized controlled trials are needed to determine the correct platelet count threshold prior to evacuation of CSDH.