Surgery for Chronic Subdural Hematoma in Patient on Anticoagulant and/or Antiplatelet Drugs | ||||
| Benha Medical Journal | ||||
| Articles in Press, Accepted Manuscript, Available Online from 25 November 2024 PDF (368.76 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/bmfj.2024.319261.2197 | ||||
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| Authors | ||||
Shawky Atef Elmeleigy1; Eslam Abo Elfetouh Abd Elaziz2; Moataz Ahmed Elawady3; Mohamed Hammad Eltantawy3; Mahmoud Saber Abd Elgawad Mohamed  4
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| 1Lecturer of Neurosurgery, Faculty of Medicine, Benha University, Egypt | ||||
| 2Professor of Neurosurgery, Head of neurosurgical department, Faculty of Medicine, Banha University, Egypt | ||||
| 3Professor of Neurosurgery, Faculty of Medicine, Benha University, Egypt | ||||
| 4MB. B.Ch, Resident of Neurosurgery, Banha University Hospitals | ||||
| Abstract | ||||
| Background: CSDH is a serious fluid collection containing blood that is located between the dura and arachnoid mater. This study aimed to evaluate the suitable timing resulting in the best outcome of surgical evacuation of CSDH in patients on anticoagulant and/or antiplatelet therapy and when to restart these drugs post operatively. Methods: This retrospective cohort study included 300 patients with CSDH on anticoagulant and/or antiplatelet drugs. Detailed history, general and neurological examination, radiological and laboratory investigations were performed. Results: Acute blood accumulation in patients who had urgent intervention more than patients who waited until elimination of effect of anticoagulant or antiplatelets before intervention, but urgent intervention is lifesaving in patient with bad neurological conditions (GCS < 12). Clinical modified Rankin score was significant higher in patients who had urgent intervention compared patients who waited until stabilization before intervention due to risk of bleeding. Delayed recurrence. Conclusion: There are high mortality and morbidity with high risk of acute blood accumulation in early evacuation of CSDH in patients on treated with these drugs. So, if patient neurologically stable (GCS ≥ 12), we can wait until elimination the effect of these drugs. On the other hand, patient with bad neurological conditions (GCS < 12), evacuation of hematoma is a mandatory whatever the general conditions. As regard restoring this medical treatment post-operative, the priority usually for the vital conditions. If it’s life-threatening conditions, we can restore those drugs as early as possible. Otherwise, we can wait as possible result in better outcome. | ||||
| Keywords | ||||
| Surgery; Chronic Subdural Hematoma; Anticoagulant; Antiplatelet; GCS | ||||
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