Effect of anti-thrombotic drugs on chronic subdural hematoma

Shi Lihai; Zhang Tiejin; Zhang Nan; Zou Feng; Kan Zhisheng

doi:10.3760/cma.j.issn.1673-4777.2014.02.011

Abstract：Objective To explore the effect of oral antithrombotic drugs on chronic subdural hematoma and recurrence.Methods Two hundred and thirty-three chronic subdural hematoma patients with drainage hole surgery in our hospital neurosurgery from January 2002 to December 2012 were analyzed.Based on the history of head trauma within 3 months,patients were divided into traumatic group and non-traumatic group.Anti-thrombotic drugs were used in all patients.Treatment time after injury in patients with traumatic brain injury group and recurrence time in all patients were analyzed.Results Seventy-one cases (67.6％) of non-trauma patients routinely had antithrombotic drugs before surgery,which was significantly higher than 36.7％ (47 cases) of trauma group patients.In traumatic brain injury group,treatment time in patients with preoperative anti-thrombotic drugs was significantly shorter than patients without using such treatment after traumatic brain injury [(27 ± 11) d vs (50 ±14)d,P ＜0.05].30 cases of non-traumatic group (42.2％) used warfarin therapy,including 1 case (1.5％) with AAA common use of warfarin,warfarin INR average of (2.77 ± 0.25).Among trauma group,20 cases (42.6％) using warfarin therapy,3 patients (6.4％) with AAA common warfarin use,warfarin INR average of (1.89 ± 0.67).Non-trauma patients admitted to hospital were significantly higher than the average INR values of trauma group (P ＜ 0.05).Recurrence rate and time to recurrence had no significant differences between patients with and without preoperative anti-thrombotic drugs.Conclusion Oral anti-thrombotic drugs can increase possibility for non-traumatic chronic subdural hematoma and accelerate traumatic chronic subdural hematoma progression.