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Published on: July 3, 2014
Atorvastatin accelerates hematoma absorption and ameliorates cognitive impairment in patients with chronic subdural
1Department of Neurosurgery, West China Hospital of Sichuan University-Ziyang Hospital and Ziyang Central Hospital, Ziyang, Sichuan, China.
Chronic subdural hematoma (CSDH) is a prevalent neurosurgical disorder in the elderly, often accompanied by cognitive impairment that severely compromises prognosis. Atorvastatin promotes hematoma absorption, exerts anti-inflammatory and neuroprotective effects, but its efficacy, cognitive improvement and safety in CSDH patients with cognitive impairment remain unclear. This study aimed to evaluate the impacts of atorvastatin on hematoma resolution, cognitive recovery, surgical conversion risk and safety in this cohort to support clinical conservative management. We conducted a single-center, non-randomized, retrospective study enrolling 67 CSDH patients with cognitive impairment between January 2020 and June 2025, who were assigned to atorvastatin group (routine treatment plus atorvastatin 20 mg nightly) or control group (routine treatment alone). Given the modest sample size and retrospective design, conclusions should be interpreted as exploratory. Primary outcomes included 6-month hematoma absorption rate, absorption grade, corrected MoCA score improvement and cognitive impairment incidence; secondary outcomes included serial hematoma volume, MoCA scores, surgical conversion rate and adverse events. Assessments were performed with the assessors blinded to the treatment group allocation. Baseline characteristics were comparable between the atorvastatin group (n = 33) and control group (n = 34). Atorvastatin significantly reduced hematoma volume and elevated MoCA scores at 1, 3 and 6 months, with higher hematoma absorption rate, lower cognitive impairment rate (6.1% vs. 26.5%) and lower surgical conversion rate (6.1% vs. 26.5%) (all P < 0.05). Hematoma absorption was moderate positively correlated with MoCA improvement (r s = 0.495, P < 0.001),suggesting a potential link, and atorvastatin was an independent protective factor for cognitive recovery (β = 0.980, P < 0.001). No severe adverse events occurred in either group, and mild adverse events were comparable, reversible and manageable. In this exploratory retrospective analysis, atorvastatin 20 mg/day significantly accelerates hematoma absorption, reduces surgical conversion and independently improves cognitive function in CSDH patients with cognitive impairment, with favorable safety. These hypothesis-generating results support its potential as a promising conservative treatment option, warranting validation in prospective trials.
Chronic subdural hematoma (CSDH) is a prevalent neurosurgical disorder in the elderly, often accompanied by cognitive impairment that severely compromises prognosis. Atorvastatin promotes hematoma absorption, exerts anti-inflammatory and neuroprotective effects, but its efficacy, cognitive improvement and safety in CSDH patients with cognitive impairment remain unclear. This study aimed to evaluate the impacts of atorvastatin on hematoma resolution, cognitive recovery, surgical conversion risk and safety in this cohort to support clinical conservative management. We conducted a single-center, non-randomized, retrospective study enrolling 67 CSDH patients with cognitive impairment between January 2020 and June 2025, who were assigned to atorvastatin group (routine treatment plus atorvastatin 20 mg nightly) or control group (routine treatment alone). Given the modest sample size and retrospective design, conclusions should be interpreted as exploratory. Primary outcomes included 6-month hematoma absorption rate, absorption grade, corrected MoCA score improvement and cognitive impairment incidence; secondary outcomes included serial hematoma volume, MoCA scores, surgical conversion rate and adverse events. Assessments were performed with the assessors blinded to the treatment group allocation. Baseline characteristics were comparable between the atorvastatin group (n = 33) and control group (n = 34). Atorvastatin significantly reduced hematoma volume and elevated MoCA scores at 1, 3 and 6 months, with higher hematoma absorption rate, lower cognitive impairment rate (6.1% vs. 26.5%) and lower surgical conversion rate (6.1% vs. 26.5%) (all P < 0.05). Hematoma absorption was moderate positively correlated with MoCA improvement (r s = 0.495, P < 0.001),suggesting a potential link, and atorvastatin was an independent protective factor for cognitive recovery (β = 0.980, P < 0.001). No severe adverse events occurred in either group, and mild adverse events were comparable, reversible and manageable. In this exploratory retrospective analysis, atorvastatin 20 mg/day significantly accelerates hematoma absorption, reduces surgical conversion and independently improves cognitive function in CSDH patients with cognitive impairment, with favorable safety. These hypothesis-generating results support its potential as a promising conservative treatment option, warranting validation in prospective trials.
