Prospective Study on the Efficacy of Orally Administered Tranexamic Acid and Goreisan for the Prevention of Recurrence After Chronic Subdural Hematoma Burr Hole Surgery

• Published in: World neurosurgery Vol. 134; pp. e549 - e553
• Main Authors: Yamada, Tetsuhisa, Natori, Yoshihiro
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.02.2020
• Subjects: Administration, Oral; Aged; Antifibrinolytic Agents - administration & dosage; Chronic subdural hematoma; Drugs, Chinese Herbal - administration & dosage; Female; Follow-Up Studies; Goreisan; Hematoma, Subdural, Chronic - diagnostic imaging; Hematoma, Subdural, Chronic - prevention & control; Hematoma, Subdural, Chronic - surgery; Humans; Male; Postoperative Hemorrhage - diagnostic imaging; Postoperative Hemorrhage - prevention & control; Recurrence; Tranexamic acid; Tranexamic Acid - administration & dosage; Treatment Outcome; AQP; Recurrence; CT; Goreisan; Chronic subdural hematoma; Tranexamic acid; EACA; CSDH; TXA
• ISSN: 1878-8750; 1878-8769
• DOI: 10.1016/j.wneu.2019.10.134

This prospective study investigated whether tranexamic acid and Goreisan effectively prevent recurrence after burr hole surgery for chronic subdural hematoma. A total of 297 patients with chronic subdural hematoma underwent initial burr hole surgery at our hospital from April 2014 to March 2018. Of these, 206 patients (250 hematomas) consented to participate in this study. Patients were randomly divided into the nonadministration, tranexamic acid, and Goreisan groups based on age. The oral administration intervention was implemented from the day after surgery, after which there was a 3-month follow-up. Recurrence rates were measured, and head computed tomography scan was used to measure the volume of residual hematoma 1 day, 1 week, and 1, 2, and 3 months after surgery. A total of 193 patients (232 hematomas) were followed-up for 3 months (82 hematomas in the nonadministration group, 72 hematomas in the tranexamic acid group, and 78 hematomas in the Goreisan group). There were no significant between-group differences in demographic characteristics, current drug treatment, comorbidities, hematoma, operation side (bilateral or unilateral), preoperative hematoma volume, and recurrence rates. At 1, 2, and 3 months, the residual hematoma volume was significantly smaller in the tranexamic acid group than in the other 2 groups. Oral administration of tranexamic acid or Goreisan does not minimize recurrence after chronic subdural hematoma burr hole surgery; however, tranexamic acid can reduce the hematoma volume.