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Tranexamic acid for chronic subdural hematoma. / Lodewijkx, Roger; Immenga, Steven; van den Berg, René et al.
In: British journal of neurosurgery, Vol. 35, No. 5, 2021, p. 564-569.Research output: Contribution to journal › Article › Academic › peer-review
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TY - JOUR
T1 - Tranexamic acid for chronic subdural hematoma
AU - Lodewijkx, Roger
AU - Immenga, Steven
AU - van den Berg, René
AU - Post, René
AU - Westerink, Lucas G.
AU - Nabuurs, Rob J. A.
AU - Can, Anil
AU - Vandertop, William Peter
AU - Verbaan, Dagmar
N1 - Publisher Copyright: © 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
PY - 2021
Y1 - 2021
N2 - Background: There is no consensus on optimal treatment for a chronic subdural hematoma (cSDH). In patients with only moderate symptoms treatment with tranexamic acid (TXA) has been suggested. We report off-label use of TXA in seven patients. Methods: Between August 2016 and May 2018 we identified seven patients for primary conservative treatment with TXA until satisfactory clinical and radiological status was achieved. Primary outcome was surgery for cSDH evacuation. Radiological follow-up was performed at regular intervals for hematoma volume measurements. Results: Five patients experienced complete resolution of symptoms, one patient had a burr-hole craniostomy five days after initiation of TXA treatment due to an increase of left-sided weakness and dysarthria and in one patient symptoms did not improve. Median follow-up was 15 weeks (range 6–25, without the operated patient). The median total volume before start of treatment was 83 mL (range 11–137) for all patients. At the last follow-up, the median total volume in the non-operated patients decreased by 73% to 33 mL (range 0–77). Conclusions: TXA could be considered as primary medical treatment in patients with a cSDH and mild symptoms. The results of current randomized clinical trials must be awaited.
AB - Background: There is no consensus on optimal treatment for a chronic subdural hematoma (cSDH). In patients with only moderate symptoms treatment with tranexamic acid (TXA) has been suggested. We report off-label use of TXA in seven patients. Methods: Between August 2016 and May 2018 we identified seven patients for primary conservative treatment with TXA until satisfactory clinical and radiological status was achieved. Primary outcome was surgery for cSDH evacuation. Radiological follow-up was performed at regular intervals for hematoma volume measurements. Results: Five patients experienced complete resolution of symptoms, one patient had a burr-hole craniostomy five days after initiation of TXA treatment due to an increase of left-sided weakness and dysarthria and in one patient symptoms did not improve. Median follow-up was 15 weeks (range 6–25, without the operated patient). The median total volume before start of treatment was 83 mL (range 11–137) for all patients. At the last follow-up, the median total volume in the non-operated patients decreased by 73% to 33 mL (range 0–77). Conclusions: TXA could be considered as primary medical treatment in patients with a cSDH and mild symptoms. The results of current randomized clinical trials must be awaited.
KW - Chronic subdural hematoma
KW - neurosurgery
KW - tranexamic acid
UR - http://www.scopus.com/inward/record.url?scp=85111728711&partnerID=8YFLogxK
U2 - 10.1080/02688697.2021.1918328
DO - 10.1080/02688697.2021.1918328
M3 - Article
C2 - 34334070
VL - 35
SP - 564
EP - 569
JO - British journal of neurosurgery
JF - British journal of neurosurgery
SN - 0268-8697
IS - 5
ER -
ID: 19266747