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Tranexamic acid for chronic subdural hematoma.

Roger Lodewijkx1, Steven Immenga1, René van den Berg2

  • 1Neurosurgical Center Amsterdam, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam, The Netherlands.

British Journal of Neurosurgery
|August 2, 2021
PubMed
Summary
This summary is machine-generated.

Tranexamic acid (TXA) shows promise for treating chronic subdural hematoma (cSDH) in patients with mild symptoms. This study suggests TXA may reduce the need for surgery, though further clinical trials are needed.

Keywords:
Chronic subdural hematomaneurosurgerytranexamic acid

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Area of Science:

  • Neurosurgery
  • Neurology
  • Medical Research

Background:

  • Optimal treatment for chronic subdural hematoma (cSDH) remains debated.
  • Tranexamic acid (TXA) is a potential therapeutic option for patients with moderate cSDH symptoms.
  • This study explores the off-label application of TXA in a small patient cohort.

Purpose of the Study:

  • To evaluate the efficacy of tranexamic acid (TXA) as a primary conservative treatment for chronic subdural hematoma (cSDH).
  • To assess the impact of TXA on symptom resolution and hematoma volume in cSDH patients.
  • To determine if TXA can obviate the need for surgical intervention in select cSDH cases.

Main Methods:

  • Seven patients with cSDH received primary conservative treatment with TXA.
  • Treatment continued until satisfactory clinical and radiological improvement was observed.
  • Radiological follow-up included regular hematoma volume measurements.

Main Results:

  • Five out of seven patients achieved complete symptom resolution with TXA.
  • A significant reduction in median hematoma volume (73%) was observed in non-operated patients.
  • One patient required surgery due to symptom progression, and another showed no improvement.

Conclusions:

  • Tranexamic acid (TXA) may be a viable primary medical treatment for chronic subdural hematoma (cSDH) with mild symptoms.
  • TXA demonstrated potential in reducing hematoma size and avoiding surgery in this patient group.
  • Results warrant consideration while awaiting outcomes from ongoing randomized clinical trials.