Related Experiment Video

Updated: Jul 19, 2025

Pre-Chiasmatic, Single Injection of Autologous Blood to Induce Experimental Subarachnoid Hemorrhage in a Rat Model
09:14

Pre-Chiasmatic, Single Injection of Autologous Blood to Induce Experimental Subarachnoid Hemorrhage in a Rat Model

Published on: June 18, 2021

2.4K

Renin-angiotensin-aldosterone system inhibitors as a risk factor for chronic subdural hematoma recurrence: A matter

Wataru Shimohigoshi1, Hajime Takase2, Tatsuya Haze3

  • 1Department of Neurosurgery, Yokohama City University Medical Center, Yokohama, Japan.

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
|August 14, 2023
PubMed

Insights

Renin-angiotensin-aldosterone system inhibitors (RAASi) may increase the risk of chronic subdural hematoma (cSDH) recurrence after surgery. This study identified RAASi use as an independent risk factor for cSDH recurrence, though its role remains debated.

Area of Science:

  • Neurosurgery
  • Pharmacology
  • Epidemiology

Background:

  • Chronic subdural hematoma (cSDH) is a prevalent neurological condition with significant long-term implications.
  • Definitive risk factors for cSDH recurrence are not fully established.
  • Renin-angiotensin-aldosterone system inhibitors (RAASi) have theoretical roles in vascular permeability and cell proliferation, potentially influencing cSDH recurrence, but evidence is conflicting.

Purpose of the Study:

  • To investigate the association between antihypertensive medications, specifically RAASi, and the risk of recurrent chronic subdural hematoma (cSDH) after surgical treatment.
  • To identify definitive risk factors for cSDH recurrence.

Main Methods:

  • Retrospective review of 203 consecutive surgically treated cSDH cases.
  • Comparison of clinical and radiological parameters between recurrent and non-recurrent cSDH groups.
  • Statistical analysis including multiple logistic regression and Cox proportional hazard models.

Main Results:

  • RAASi use was observed in 33.5% of patients, with 18.2% experiencing recurrence within 60 days.
  • Multiple logistic regression indicated RAASi use as a significant risk factor for cSDH recurrence (OR 2.49; 95% CI 1.16–5.42).
  • Cox proportional hazard modeling confirmed RAASi use as an independent risk factor for cSDH recurrence.

Conclusions:

  • RAASi use is suggested as a potential risk factor for chronic subdural hematoma recurrence.
  • The precise role of RAASi in cSDH pathogenesis and recurrence requires further investigation.
  • Additional research into the hematoma microenvironment is recommended for a deeper understanding.
Abstract

Keywords:
Chronic subdural hematomaPermeabilityRecurrenceRenin-angiotensin-aldosterone systemRisk factor

More Related Videos

Double Direct Injection of Blood into the Cisterna Magna as a Model of Subarachnoid Hemorrhage10:34

Double Direct Injection of Blood into the Cisterna Magna as a Model of Subarachnoid Hemorrhage

Published on: August 30, 2020

10.6K
Intracranial Pressure Monitoring In Nontraumatic Intraventricular Hemorrhage Rodent Model08:18

Intracranial Pressure Monitoring In Nontraumatic Intraventricular Hemorrhage Rodent Model

Published on: February 8, 2022

2.5K

Related Concept Videos

Antihypertensive Drugs: Direct Renin Inhibitors01:25

Antihypertensive Drugs: Direct Renin Inhibitors

The renin-angiotensin-aldosterone system (RAAS) is an intricate physiological pathway involving numerous enzymes and hormones, including renin, angiotensin-converting enzyme (ACE), angiotensin I and II, and aldosterone. Imbalances within this system increase the production of angiotensin II and aldosterone. Increased angiotensin II levels promote vasoconstriction and blood pressure elevation. Concurrently, higher aldosterone levels stimulate sodium and water reabsorption in the kidneys,...
682
Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
463
Antihypertensive Drugs: Angiotensin-Converting Enzyme Inhibitors01:30

Antihypertensive Drugs: Angiotensin-Converting Enzyme Inhibitors

Angiotensin-converting enzyme (ACE), a vital component of the renin-angiotensin-aldosterone system, is abundant in lung endothelial cells. ACE converts the inactive decapeptide, angiotensin I, into the active octapeptide, angiotensin II. This potent vasoconstrictor narrows blood vessels, increasing resistance to blood flow and elevating blood pressure. Angiotensin II also stimulates aldosterone production, encouraging kidney cells to reabsorb more sodium and water from urine, thereby increasing...
690
Hormonal Regulation01:33

Hormonal Regulation

The renin-aldosterone system is an endocrine system which guides the renal absorption of water and electrolytes, thus managing blood pressure and osmoregulation. Activation of the system begins in the kidneys with a small cluster of cells adjacent to the afferent and efferent blood vessels of the renal corpuscle. As the nephrons are filtering blood, juxtaglomerular cells monitor blood pressure. If they detect a decrease in pressure, they release the hormone renin into the bloodstream.
33.3K
Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
35
Aneurysm III: Interprofessional Care01:26

Aneurysm III: Interprofessional Care

Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
10