Herbal Medicine, Oreongsan for Recurrent Chronic Subdural Hematoma: A Case Report

Recently, the East-Asian herbal complex Oreongsan (Goreisan in Japanese and Wulingsan in Chinese) has been noted for its usefulness in preventing postoperative recurrence of chronic subdural hematoma (CSDH). Here, we present a case of CSDH, an 84-year-old man which had recurred four times, despite three previous burr-hole surgeries. Following the fourth burr-hole surgery, an herbal medicine called Oreongsan (TJ-17, Tsumura, Japan, 15g/d) was administered to the patient in hopes of preventing another CSDH recurrence. This case was successfully treated with Oreongsan in an attempt to prevent any further recurrences. The potential mechanism of action of Oreongsan is hydrostatic modulation. The inhibitory effect of the Oreongsan on aquaporin-4 found on the CSDH membrane could contribute to its ability to reduce and prevent the aggravation of SDH.